What is immunotherapy?

About immunotherapy

Immunotherapy is a standard treatment for some types of cancer. And it is in ​clinical trials​ for other types of cancer.

There are different types of immunotherapy. We have information about the following types of immunotherapies:

• monoclonal antibodies (mAbs)

• checkpoint inhibitors

• vaccines

• cytokines

• CAR T-cell therapy

Some types of immunotherapies are also called targeted treatments or biological therapies. 

Find out more about targeted cancer drugs

The immune system and immunotherapy

Our immune system works to protect the body against infection, illness and disease. It can also help protect us from the development of cancer. 

The immune system includes the ​lymph glands, ​spleen​ and ​white blood cells​. Normally, it can spot and destroy faulty cells in the body, stopping cancer developing. But a cancer might develop when:

• you have a low number of white blood cells so the immune system is too weak to be able to recognise and kill the cancer cells

• the cancer cells produce signals that stop the immune system from attacking it

• the cancer cells hide or escape from the immune system

Knowing this helps doctors understand and find ways to develop treatments. There are several different types of immunotherapy treatments. These work in different ways to help our immune system recognise and attack cancer cells.

Find out more about the immune system

Who can have immunotherapy?

Whether you have immunotherapy depends on:

• the type of cancer you have

• how far your cancer has spread (the stage) 

• other cancer treatments you’ve had

Testing

Before you have some types of immunotherapy you might need to have tests using some of your cancer cells or a blood sample. This is to find out whether the treatment is likely to work. These tests look for changes in certain proteins or ​genes​. 

Your cancer specialist can tell you if this applies to your treatment. This is not the case for all immunotherapies and you don’t always need this test.

To test your cancer cells, your specialist needs a sample (biopsy) of your cancer. They might be able to use some tissue from a biopsy or operation you have already had.

Types of immunotherapy

Immunotherapy treatments do not always fit easily into a certain type or group of treatments. This is because some drugs or treatments work in more than one way and belong to more than one group. So you might hear the same drug or treatment called different things.

For example, a type of immunotherapy called checkpoint inhibitors are also described as a monoclonal antibody or targeted treatment.

Ask your specialist about immunotherapy. They can explain:

• whether this treatment is suitable for you

• what the aim of treatment would be

• what it would involve and the side effects

Targeted cancer drugs and immunotherapy

Monoclonal antibodies (mAbs)

Antibodies are found naturally in our blood and help us to fight infection. MAb therapies mimic natural antibodies but are made in a laboratory. Monoclonal means all one type. So each mAb therapy is a lot of copies of one type of antibody.

MAbs recognise and attach to specific proteins on the surface of cancer cells. Many different mAbs are available to treat cancer. They work in different ways and some work in more than one way. They might do one of the following:

• trigger the immune system

• help the immune system to attack cancer

Read more about mAbs that have an effect on the immune system

Checkpoint inhibitors

Cancer can sometimes switch off the immune cells, so it isn't able to recognise and attack cancer cells. Checkpoint inhibitors are mAbs that work by switching the immune system back on to recognise and attack cancer cells.

Checkpoint inhibitors stop the proteins on the cancer cells or T cells from pushing the stop button. This turns the immune system back on. The T cells are then able to grow and attack the cancer cells.

Read about checkpoint inhibitors

Vaccines to treat cancer

Vaccines can help the immune system to recognise and attack cancer cells.

In the same way that vaccines work against diseases, the vaccines are made to recognise proteins that are on particular cancer cells. This helps the immune system to recognise and attack those particular cancer cells.

Some people with melanoma skin cancer have a drug called talimogene laherparepvec (T-VEC). It’s a weakened form of the cold sore virus that has been changed in the laboratory. The changed virus grows in the cancer cells and destroys them. It also works by helping the immune system recognise and attack cancer cells.

Researchers are looking at other vaccines to help the immune system fight cancer.

Read more about vaccines to treat cancer

Cytokines

Cytokines are a group of proteins in the body that play an important part in boosting the immune system.

Interferon is a type of cytokine found in the body. Scientists have developed man made version of this to treat a group of cancers called myeloproliferative disorders such as polycythaemia vera (PV) and essential thrombocythaemia (ET).

Find out more about cytokines

CAR T-cell therapy

This treatment changes the genes in a person’s ​T cells​ to help them recognise and kill cancer cells. T cells are a type of white blood cell. Changing the T cell in this way is called genetically engineering the T cell.

It is available as a possible treatment for some people including children with leukaemia and some adults with lymphoma. People with other types of cancer might have it as part of a clinical trial. 

Find out more about CAR T-cell therapy