What is Immunotherapy?
Immunotherapy uses the power of your immune system to identify and attack cancer cells, stripping away the camouflage that these cells use to hide. Some forms of immunotherapy also enhance the body's immune response to cancer by boosting the number and activity of immune cells, training the immune cells to recognise cancer-specific antigens, and allowing for a more targeted and efficient approach to cancer care.
Five Categories of Immunotherapy
Modern research highlights five major categories of immunotherapy that prove to be highly effective in the field of integrative oncology. Each approach focuses on different mechanisms to stimulate the immune system to detect and respond to cancer cells.
Unfortunately, these novel immunotherapy approaches can be difficult to access, so we have taken a special interest in personalising supportive care plans for patients at Sanctura to include both novel and conventional immunotherapies.
Checkpoint Inhibitors
Investigational Peptide Vaccine Approaches
Investigational Dendritic Cell Approaches
Oncolytic Virus Therapy
CAR-T Therapy
What is Personalised Immunotherapy in Oncology?
Personalised immunotherapy in oncology is a tailored approach to cancer care that leverages the patient's unique immune system characteristics to design more effective supportive approaches. It involves customising immunotherapy based on an individual's tumour profile, genetic makeup, and immune system responses, aiming to maximise the approach's effectiveness while minimising side effects.
Immunotherapy Tests
Tumour Profiling and Genetic Analysis
Tumour Profiling and Genetic AnalysisImmune Profiling
Immune ProfilingBiomarker Testing
Biomarker TestingTypes of Personalised Immunotherapy
Immunotherapy itself is a type of cancer care approach that helps the body's immune system recognise and fight cancer cells. Personalised immunotherapy takes this a step further by fine-tuning the approach to target the specific mechanisms by which a patient's immune system interacts with their cancer.
Checkpoint Inhibitors
Checkpoint inhibitors are drugs that block proteins like PD-1, PD-L1, or CTLA-4, which cancer cells use to "hide" from the immune system. Personalised immunotherapy tailors checkpoint inhibitor use based on the patient's specific tumour markers or immune checkpoint expression.
Common checkpoint inhibitors include nivolumab, pembrolizumab, and ipilimumab, which can be prescribed based on a patient's tumour PD-L1 levels or other biomarkers.
CAR-T Cell Therapy
Chimeric Antigen Receptor (CAR)-T cell therapy is a highly personalised form of immunotherapy. It involves extracting a patient's T cells, genetically engineering them to express receptors specific to the cancer, and then reinfusing them into the patient to target and respond to cancer cells.
CAR-T therapy has shown remarkable results in supporting patients with certain blood cancers such as leukaemia and lymphoma, and is also being explored for patients with solid tumours.
Tumour-Infiltrating Lymphocyte (TIL) Therapy
TIL therapy involves harvesting a patient's own tumour-infiltrating lymphocytes (immune cells that have migrated into the tumour), expanding them in the lab and reintroducing them into the patient. This supports the immune system's natural ability to respond to the tumour.
TIL therapy is highly personalised because it uses the patient's own immune cells, which are already primed to recognise the tumour.
Investigational Cancer Vaccine Approaches
Personalised vaccine-based approaches are developed by identifying unique tumour antigens (neoantigens) specific to the patient's cancer. These stimulate the immune system to recognise and respond to cancer cells displaying these antigens.
Personalised vaccine-based approaches are still largely in the research phase but show promise, particularly in melanoma and other cancers where neoantigen identification is more feasible.
Adoptive Cell Therapy (ACT)
Besides CAR-T and TIL therapies, other forms of adoptive cell transfer are used in personalised immunotherapy. These involve selecting and expanding specific immune cells that show a natural ability to respond to cancer, optimising their effectiveness for each patient.
Oncolytic Virus Therapy
Oncolytic viruses are genetically modified viruses that selectively infect and respond to cancer cells. In personalised approaches, these viruses can be engineered to carry specific genetic information tailored to the patient's tumour, helping the immune system recognise and respond to the cancer.
Combination Care Approaches
Personalised immunotherapy often involves combining different care approaches based on a patient's unique tumour profile. This can include combining checkpoint inhibitors with conventional therapies (chemotherapy, radiation), CAR-T cell therapy, or targeted therapies to support immune responses and improve quality of life.
Monitoring and Adaptive Approach
Personalised immunotherapy requires continuous monitoring of how the patient's immune system responds. Blood tests, imaging, and immune profiling can help oncologists adjust the approach if the tumour evolves or if new mutations emerge.
Liquid biopsies — analysing circulating tumour DNA (ctDNA) in the blood — can provide real-time insights into how a tumour changes and how the immune system responds.
Benefits and challenges of Personalised Immunotherapy
Immunotherapy Benefits in Oncology Support
Greater Effectiveness
Reduced Side Effects
Improved Quality of Life for Resistant Cancers
Targets Tumour Heterogeneity.
Immunotherapy Challenges in Oncology Support
Cost and Accessibility
Complexity of Tumour Biology
Not All Patients Respond
Side Effects
Why is Immunotherapy Important?
Immunotherapy is vital in oncology because it offers a paradigm shift toward more effective, durable, and patient-specific cancer care approaches. This will improve quality of life and provide new hope for those battling this disease. It offers durable responses by "training" the immune system to recognise cancer, with fewer side effects than traditional therapies. Targeted approaches like checkpoint inhibitors, CAR-T cell therapy, and investigational vaccine-based approaches enable precision care, making it effective across various cancer types, including advanced and resistant cases.
Who is Immunotherapy For?
Immunotherapy is for individuals with various types of cancer. However, its suitability depends on specific factors such as the type and stage of cancer, the patient's overall health, and the tumour's molecular and genetic characteristics.
Immunotherapy is suitable for patients with certain cancers, particularly those with advanced or metastatic disease, specific biomarkers (e.g., PD-L1, MSI-H, TMB), or cancers responsive to approaches like checkpoint inhibitors or CAR-T cell therapy.
It benefits those who cannot tolerate conventional oncology care and may be used alone or in combination with other supportive approaches to enhance overall wellbeing. However, it may not be appropriate for individuals with autoimmune diseases, transplant histories, or tumours lacking immunotherapy-responsive biomarkers.
Careful assessment by a specialist is crucial to determine eligibility.