ImmunotherapySara Engh & Tenzin Yiga

Role of the Immune system➔ Defends against pathogens such as

bacteria, fungi, and viruses that enter the body

➔ Responds to antigens on the surface of materials to relay whether they are foreign or not

➔ Cancer cells have antigens that are only slightly different from normal cells and can be missed

➔ “Cancer cells are less like soldiers of an invading army and more like traitors within the ranks of the human cell population” (American Cancer Society, 2014)

http://www.airheads1.com/o2_for_immune_system.php

What is Immunotherapy

➔ Cancer immunotherapy is a modality that uses a person’s own immune system to help combat diseases such as cancer◆ Uses man-made immune system proteins in

the lab or materials made by the body➔ AKA: biotherapy➔ Still not clear how the process actually helps

treat cancer but is thought to either slow/stop tumor growth or increase the body’s natural ability to find and eliminate cancerous cells

Types of Immunotherapies

➔ Monoclonal antibodies

➔ Non-specific immunotherapies

➔ Cancer vaccines

http://www.huffingtonpost.com/2013/11/04/provenge-cancer-vaccine_n_4181851.html

Monoclonal antibodies (mAbs)

➔ Monoclonal antibodies are lab-made and injected intravenously into the patient (Examples of FDA approved mAbs: Herceptin, Rituxan, Campath…)

➔ Target specific proteins on the surface of cancer cells or supporting cells

➔ Outcomes◆ Assist immune system to destroy cancer

cells, prevent growth, deliver radiation, diagnose cancers

Non-specific immunotherapies

➔ 2 most common non-specific immunotherapies◆ Interferons

● Help immune system by potentially slowing down cancer growth

◆ Interleukins● Help immune system to produce more cells

that fight off cancer cells

Cancer Vaccines➔ Vaccines expose the body to the antigen of a

certain disease or pathogen, which then trains the immune system to recognize the material

➔ Prevention vaccines◆ pts with no symptoms (proactive)◆ i.e. HPV vaccine (Gardasil, Cervarix)

➔ Treatment vaccines◆ helps immune system fight certain cancers by

training it to recognize the cancer cells◆ i.e. Provenge is the only approved treatment

vaccine in the U.S. (metastatic prostate cancer)

Benefits and Side Effects of Immunotherapy

➔ Fewer harsh side effects compared to chemotherapy and radiation therapy◆ Possible side effects of immunotherapy are fever, chills,

weakness, headache, nausea, vomiting, diarrhea, low BP, and rashes (American Cancer Society, 2014)

➔ Does not cause secondary malignancies ➔ Can increase remission period or decrease the chance of

recurrence ◆ Memory cells in the immune system ◆ GP2 vaccine has shown to reduce recurrence rates in

breast cancer patients by 57% (MD Anderson Cancer Center, 2014)

Types of Cancers Immunotherapy is Used for

➔ Prostate Cancer (cell-based immunotherapy)

◆ Provenge, approved by the FDA in 2010

◆ Uses patient’s own WBC, most of which are dendritic and infuses them with the antigen prostatic acid phosphatase (PAP) and signaling factor that helps with maturation

◆ extends survival rates by several months (American Cancer Society, 2014)

➔ Melanoma (cytokine immunotherapy)◆ 1998, the FDA approved interleukin-2

(IL-2) to help treat advanced melanoma and another agent Yervoy became the first proven immunotherapy agent to help extend the life of metastatic patients by 1-2 years in 2011 (Cancer Research Institute, 2014)

http://www.fightcancerwithimmunotherapy.com/ImmunotherapyAndCancer/StateOfCancerImmunotherapy.aspx

Immunotherapy Research➔ The FDA has just granted a Breakthrough Therapy Designation to the

pharmaceutical company, Roche, for its promising MPDL3280A (anti-PDL1) immunotherapy used to treat certain types of non-small cell lung cancer (NSCLC) (Drug Discovery & Development, 2015)

➔ Leukemia (Breakthrough Therapy)Chimeric antigen receptor (CAR) T cell therapy is pending approval from the

FDA, clinical trials have been very effective. One trial in June of 2011, Acute Lymphoblastic Leukemia treatment results obtained 100% remissions in children and 90% in adults (Cancer Research Institute, 2014)

➔ Immune Checkpoint Inhibitors - blocks the immune checkpoint protein which allows the immune system to recognize the tumor and initiate an immune response◆ MD Anderson Medical Center developed an antibody, anti-CTLA-4, to block

this protein ◆ Study done on metastatic renal cell carcinoma and has shown to cause

tumor regression (Hale, 2014)

References

Cancer Immunotherapy . (2014, December 8). In American Cancer Society. Retrieved February 16, 2014 from http://www.cancer.org/acs/groups/cid/documents/webcontent/003013-pdf.pdf

Collins, S. (2014, November 4). Immunotherapy Brings New Hope to Cancer Fight. In WebMD. Retrieved February 16, 2015 from http://www.webmd.com/cancer/news/20141104/immunotherapy-brings-new-hope-cancer-fight

FDA Grants Breakthrough Therapy Designation to Roche's Lung Cancer Immunotherapy. (2015, February). In Drug Discovery & Development. Retrieved February 16, 2015 from http://www.dddmag.com/news/2015/02/fda-grants-breakthrough-therapy-designation-roches-lung-cancer-immunotherapy

Melanoma. (2014, August). In Cancer Research Institute. Retrieved February 17, 2015 from http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers/melanoma

Novel Immunotherapy Vaccine Decreases Recurrence in HER2 Positive Breast Cancer Patients. (2014, September 5). In MD Anderson Cancer Center. Retrieved February 17, 2015, from http://www.mdanderson.org/newsroom/news-releases/2014/vaccine-decreases-reoccurence-her2-breast-cancer.htmlOxygen for the Immune System. (2014). In Airheads. Retrieved February 17, 2015, from http://www.airheads1.com/o2_for_immune_system.php

Platzman Weinstock, C. (2013, November 4). The Latest Weapon in the Fight Against Cancer. In Huffington Post. Retrieved from http://www.huffingtonpost.com/2013/11/04/provenge-cancer-vaccine_n_4181851.html

State of Cancer Immunotherapy. (2014, June). Fight Cancer With Immunotherapy. Retrieved Februatry 16, 2015 from <http://www.fightcancerwithimmunotherapy.com/ImmunotherapyAndCancer/StateOfCancerImmunotherapy.aspx> What Is Cancer Immunotherapy?. (2014, September 5). In American Cancer Society. Retrieved February 16, 2015 from http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-what-is-immunotherapy

What Is Immunotherapy?. (2013, March). In Cancer.Net. Retrieved February 16, 2015 from http://www.cancer.net/navigating-cancer-care/how-cancer-treated/immunotherapy-and-vaccines/what-immunotherapy