September 12, 2022
Dr. Viraj Lavingia, Director : GI subspeciality in Medical Oncology HCG Cancer Centre, Ahmedabad
When it is cancer, patients often want something that miraculously pulls them out of the clutches of this dreaded disease. The fear, the dilemma, the desperation, and fading hope can make patients look for something that quickly, painlessly, and comfortably cures cancer. But does something like that exist?
Let’s take immunotherapy, for example. A quick Google search will tell you that there are various types of immunotherapies. However, only an experienced medical oncologist can tell which type of immunotherapy is proven to show results and is the right option for you.
Therefore, it is important for cancer patients, their caregivers, and their family members to gather as much “right” information as possible, learn the different options available, understand the consequences, and accordingly make health decisions.
Understanding the Types of Immunotherapies
Immunotherapy, or biologic therapy, is a promising treatment approach for cancer. This treatment is often administered intravenously, and it is found to effectively treat more than 20 types of cancer with good survival rates.
It works by stimulating the patient’s immune system to fight against cancer. It may use one of the two pathways:
- By triggering or strengthening your immune system’s natural defences to make it work harder to detect and destroy cancer cells.
- By creating synthetic substances that are identical to immune system components in the lab, to repair or enhance the overall capacity of the immune system to detect and attack cancer cells.
There are different types of immunotherapies. However, only some of them are proven to treat cancer with positive clinical outcomes.
Immune Checkpoint Inhibitors: Our immune system employs a unique system of checkpoints or brakes that prevents the immune cells from attacking our body’s own healthy cells. Cancer cells can manipulate these checkpoints to recognise them as healthy cells. This stops the immune system from identifying cancer cells and attacking them.
Immune checkpoint inhibitors are a type of immunotherapy drug, and they work by blocking the checkpoint proteins on T-cells from binding to the partner proteins present on tumour cells. This will allow the T-cells to kill cancer cells.
The FDA has approved a good number of immune checkpoint inhibitors, and they are found to deliver good clinical outcomes for various types of cancer.
Adoptive Cell Therapies: This approach involves the removal of the patient’s own immune cells, culturing them or re-engineering them, and injecting them back into the patient’s body. This helps in enhancing the ability of immune cells to destroy more cancer cells.
Tumour-infiltrating lymphocyte (TIL) therapy, CAR T-cell therapy, engineered T-cell receptor (TCR) therapy, dendritic cell therapy, and natural killer (NK) cell therapy are the major types of adoptive cell therapy.
There is no sufficient data on the efficacy of these treatments. Researchers are still looking for new ways to make these more effective and safer for patients.
Despite the lack of evidence, a few of these treatments are hailed as miraculous cures and are widely popular on the internet. It is important for patients to understand that cancer needs evidence-based treatment approaches and ensure that the treatment they are undergoing is proven to show the desired results while also ensuring their safety.
Monoclonal Antibodies: Antibodies are protein molecules produced by the immune system in response to germs (viruses and bacteria) that can cause diseases. They work by recognising specific targets called antigens on these foreign particles and attacking them.
Monoclonal antibodies, on the other hand, are molecules synthesised in laboratories, and they work like natural antibodies. In the oncology space, these MABs are being used to target cancer cells and destroy them.
The FDA has approved quite a few monoclonal antibodies for different types of cancer. More studies are being carried out exploring the efficacy of this immunotherapy form on other types of cancers.
Cancer Vaccines: Cancer vaccines are created using the particles of dead cancer cells or immune system cells. The FDA has approved four vaccines (for liver and gynaecological cancers) for cancer prevention and three vaccines (prostate cancer, skin cancer, and early-stage bladder cancer) for cancer treatment.
More studies are being carried out on cancer vaccines for different cancer types.
Immune System Modulators: Immune system modulators work by stimulating the immune system to attack cancer cells. Cytokines and interferons are the two most common types of immune system modulators. Sometimes, checkpoint inhibitors are also called immune system modulators as they regulate how the immune system functions.
Importance of Opting for FDA-approved Cancer Treatments
It is normal for cancer patients to look for something that can treat cancer without pain or discomfort and help them become cancer-free in no time. However, patients must know that we are still on the way to discovering something like that, and till then, they must rely on evidence-based treatments to have better survival chances.
Recent developments in the field of immunotherapy clearly indicate that we are getting closer to curing cancer with simpler approaches—exactly the way patients want.
Recently, in the month of June, researchers at Memorial Sloan Kettering Cancer Centre, New York, conducted a clinical trial on 18 rectal cancer patients with dostarlimab, a monoclonal antibody. For the first time in the history of cancer clinical trials, this trial reported 100% eradication of tumours with no significant side effects.
Every drug or treatment approach must be clinically studied and approved by the FDA before they are widely used. This is important for the safety and well-being of the patients. The FDA uses stringent protocols to assess the effectiveness and safety of new drugs or new treatment approaches to ensure that the patients who receive them are able to benefit from them without any health risks.
Treatments Without Evidence: What Should You Do?
By now, you should already know that there is no “magic pill” that can make you cancer-free in no time.
While looking for treatment options, it is normal for patients to come across treatments that claim to cure cancer once and for all—the first thing you should do when you come across something like that is to look for evidence. Check if they have had clinical trials conducted on them and are approved by the FDA.
If they are not approved by the FDA, you should ideally avoid considering them. However, if you still think that a particular treatment can help you despite the lack of evidence, you should talk to a certified oncologist, as they will be able to tell you if that treatment can help your condition.
Considering Clinical Trials to Try New Treatments
In some cases, patients receive treatments whose efficacy is yet to be proven, and that is by taking part in clinical trials. Clinical trials are usually recommended for patients who have exhausted all their treatment options. However, in some cases, even patients with early-stage cancers opt for clinical trials.
It is normal for patients to wonder why it is okay to try a new drug during a clinical trial, but the same is considered unsafe outside of it. The reason is safety.
During clinical trials, the participants or patients are monitored closely throughout the trial. If any patient shows an adverse reaction or has any concerns, the doctors’ team is close by to address them immediately and provide them with the right care. However, that is not the case outside of a clinical trial. The patient’s safety may be in question, and if the treatment does not work, the patient’s survival chances may also be affected.
Making Informed Health Decisions—The Key to Winning Over Cancer
Whenever there is a new treatment in the oncology space, there are also numerous myths that surround that treatment. Unfortunately, a small group of patients end up believing those myths and making health decisions based on them. As one can deduce, health decisions made based on myths do not lead to desirable clinical outcomes and can negatively impact survival rates too.
Hence, it is important for patients and caregivers to get their details right, before the treatment begins. The first step towards receiving the right treatment is choosing the right specialist, who will ensure that you receive appropriate care the very first time.