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Immunotherapy is a treatment option for a growing number of cancers. Unlike traditional treatments like chemotherapy and radiation therapy, immunotherapies do not target the cancer itself.
“At times, our immune system can become tolerant to cancer for various reasons,” says Aung Naing, M.D., who leads an immunotherapy working group in MD Anderson’s Phase I clinical trials program. “With immunotherapy, we are trying to harness or reinvigorate the immune system so that it recognizes and attacks the cancer instead of being tolerant.”
There are several types of immunotherapy.
1.Immune checkpoint inhibitors work by blocking checkpoint proteins -- including CTLA-4, PD-L1 and PD-1 -- on the surface of T cells. These proteins normally prevent T cells from attacking healthy cells. Approved checkpoint inhibitors include:
anti-CTLA-4 therapy ipilimumab
anti-PD-1 therapies pembrolizumab, nivolumab and cemiplimab
anti-PD-L1 therapies atezolizumab, avelumab and durvalumab
2. Adoptive cellular therapies are another form of immunotherapy. The only Food and Drug Administration (FDA)-approved options are CAR T cell therapies, which are created from T cells taken from the patient. The cells are engineered to better recognize the cancer, expanded to large numbers and given back to the patient. FDA-approved CAR T cell therapies include brexucabtagene autoleucel, tisagenlecleucel and axicabtagene ciloleucel.
3. Cancer vaccines train the body to recognize specific features of the cancer and stimulate the immune system to attack. The only approved cancer vaccine is sipuleucel-T.
4. Сytokine therapies rely on immune proteins called interferons and interleukins to stimulate immune activity. The main cytokines that have been approved for cancer treatment are interleukin-2 and interferon alpha.