Fighting Cancer with Immunotherapy: What is it and how does it work?

We have a remarkable immune system, capable of detecting rogue cells and foreign invaders, destroying them on impact.  Tumor cells, however, have developed ways to not only evade the immune response, but also to co-opt it for its own advantage (Hallmarks of Cancer).  With a deeper understanding of these processes, cancer immunotherapy is one of the newest tricks in our cancer treatment bag.  It is also a major topic at conferences both in Canada (Conferences) and globally.  Immunotherapy even pops up in the mainstream news and on social media frequently.  Whether you’re a patient currently treated using immunotherapy or are just curious about the latest cancer research news, you’ve come to the right place! This article is a stepping-stone to a better understanding of cancer immunotherapy. 

More than 100 years ago, William B Coley, the father of immunotherapy and a New York surgeon, injected bacteria into a patient with cancer.  Such an experiment was the first to suggest that a bacterial injection could mount an inflammatory response, bringing immune cells in contact with the tumor and subsequently killing these tumor cells.  100 years ago, this practice was rudimentary and not necessarily advantageous to the patient.  Now, with our advanced knowledge of the immune system and tumor biology, we can offer several immunological approaches to kill cancer cells.  

Immunotherapy can refer to any one of several different types of therapies that use different aspects of immunology.  There are four main categories:


Monoclonal Antibodies 
Antibodies are used by the immune system to recognize foreign bodies in the body.  Monoclonal antibodies come from a single source and are highly specific for their target.  In cancer therapy, monoclonal antibodies are given to the patient exogenously.  These antibodies can target different components of cancer cells or immune systems and alter the activity of the target cells.  For example, Her2+ breast cancer can be treated with Herceptin; Ipilimumab enhances the anti-tumor immune response by binding to and inhibiting an inhibitor of the immune system. Because these antibodies are targeted they can also be used to specially act as carriers for more non-specific drugs (chemotherapy) or radiation, directing the action of these less specific forms of therapy.

Interferons and Interleukins
Interferons and interleukins are cytokines, or messengers, that are secreted by immune cells to elicit a desired effect.  Without going into specific details, interferons and interleukins essentially act as activators of the immune system.  Therefore, to jumpstart the immune system or increase its activity in a cancer setting, extra interferons or interleukins can be administered as therapy.  This type of therapy will function in a non-specific manner, activating the immune system’s response to not only the cancer cells present but throughout all areas of the body.

Treatment vaccine is a vaccine that trains the immune system to recognize cancer. These vaccines include portions of cancer or cancer cells, priming the immune system to recognize and destroy cancer cells.  These vaccines may also contain additional substances, such as the interleukins that we’ve already discussed, that can further enhance the immune response.  A current example of this type of therapy is sipuleucel-t, which has shown benefit in prostate cancer.

Oncolytic vaccine is type of treatment vaccine, but in addition to activating the immune system, an oncolytic vaccine also contains a specific type of oncolytic virus that can also specifically kill cancer cells.  Literally defined, oncolytic refers to the ability to lyse or split open – in this case, cancer cells.  Therefore, oncolytic vaccines are composed of viruses that specifically target cancer cells, and upon entering them, rupture the cancer cells.  Such rapid cell death initiates an immune-stimulating inflammatory response.  In addition, these vaccines are also designed to prime the immune system to detect and kill cancer.  Such a system can provide a longer, more sustained response and may be particularly important in preventing disease recurrence.  The world’s first clinical trial assessing the feasibility and effectiveness of this type of therapy was launched in Canada by renowned researcher John Bell in late 2015 (Clinical Trial).


The field of cancer immunotherapy is constantly evolving and the types of therapies are ever increasing.  With more research, we will better understand how this type of therapy works and how to maximize its impact by combining immunotherapy with existing therapeutic options. Stay tuned for more exciting details as we uncover the intricacies behind this new therapeutic!   




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