Immunotherapy Cancer Treatment FAQ and Patient
Stories

Your immune system fights infections and diseases in your body. Immunotherapy is a kind of biological therapy or treatment that uses your immune system to fight cancer.

Immunotherapy is still relatively new which makes its success a bit hard to predict. It’s also focused on some of the more common cancers.

Immunotherapy as cancer treatment

The immune system is what finds and destroys abnormal cells, oftentimes responsible for preventing cancer or stopping its growth.

One such example are tumor-infiltrating lymphocytes, or TILs, which are immune cells that are sometimes found in or near tumors. If patients have tumors with TILs, they tend to have better results than those who don’t.

Immunotherapy as a cancer therapy helps use the immune system to target and destroy cancer cells.

Types of immunotherapy

There are a few main kinds of immunotherapy used as cancer treatment, including:

• T-cell transfer therapy
  This kind of treatment increases the ability of T cells to act against cancer. The process requires immune cells to be taken from the patient. Those cells are studied in a lab where the most active immune cells are chosen, grown, and then sent back to be put into the patient through an IV. CAR T-Cell therapy is one of the most well-known.
• Immune checkpoint inhibitors
  These drugs block immune checkpoints, which are a part of the immune system. The immune checkpoints ensure immune responses are within normal range. By blocking these checkpoints, the immune cells are able to react more strongly to cancer cells.
• Immune system modulators
  These modulators increase the immune system’s response to and against cancer. Some of them target specific areas of the immune system, some more generally.
• Monoclonal antibodies
  These antibodies are lab-created proteins that are formulated to bind to cancer cells. These are also referred to as therapeutic antibodies.
• Treatment vaccines
  This is not the same type of vaccine used to prevent diseases. This is a type of immunotherapy that acts against cancer by increasing the immune system’s response to cancer.

Common cancers treated with immunotherapy

This type of cancer treatment is less common compared to chemotherapy, radiation therapy, and surgery. Some of the more commonly treated cancers using immunotherapy include:

• Bladder cancer
• Head and neck cancers
• Hodgkin lymphoma
• Kidney cancer
• Lung cancer
• Non-Hodgkin lymphoma

Immunotherapy side effects

As with all cancer treatments, the side effects vary depending on the patient. No two people will track exactly the same. Factors that may contribute to what side effects a patient feels include:

• State of health before treatment
• Cancer type
• Cancer stage
• Immunotherapy type
• Dosage

There are some side effects that are more commonly experienced, regardless of the immunotherapy type:

• Skin reaction at needle site
  • May include pain, soreness, swelling, itchiness, rash, and redness
• Flu-like symptoms
  • May include chills, fever, headache, problems breathing, dizziness, nausea, vomiting, muscle/joint aches, fatigue, weakness, low/high blood pressure
• Diarrhea
• Sinus congestion
• Swelling, weight gain (as a result of fluid retention)
• Heart palpitations
• Higher risk of infection

There are side effects more associated with type of immunotherapy. For a more comprehensive list, visit the National Cancer Institute page on immunotherapy side effects.

Ways immunotherapy is given

• Intravenous (IV)
  The immunotherapy goes directly into a vein.
• Oral
  The immunotherapy comes in pills or capsules that you swallow.
• Topical
  The immunotherapy comes in a cream that you rub onto your skin. This type of immunotherapy can be used for very early skin cancer.
• Intravesical
  The immunotherapy goes directly into the bladder.

Immunotherapy patient stories and experiences

Car T-Cell Therapy

William Y., Acute Lymphoblastic Leukemia (ALL)



1st symptoms: Extreme fatigue, achey hands
Treatment: Chemotherapy, CAR T-Cell therapy
...

Jacqueline Barrientos, MD



Role: Hematologist, researcher
Focus: Chronic lymphocytic leukemia (CLL), lymphoma, 17p Deletion (Ibrutinib, Acalabrutinib, Venetoclax), IgHV mutation
Provider: Northwell Health (NYC)
...

Tim Fenske, MD, MS



Role: Hematologist-Oncologist
Focus: chronic lymphocytic leukemia (CLL) & leukemia and lymphoma | CAR T, targeted therapy
Provider: Medical College of Wisconsin
...

Shahzad B., Refractory Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4



Symptoms: Extreme fatigue
Treatment: R&B, R-ICE, R-EPOCH, CAR T-cell therapy (cell-based gene therapy)
...

Sonia S., Primary Mediastinal (PMBCL), Relapse, CAR T-Cell Therapy



1st Symptoms: Chest pain, superior vena cava syndrome (SVCS); persistent, dry coughs, headaches
Treatment: (1st Line) R-CHOP chemotherapy, 6 cycles (2nd Line) R-ICE Chemotherapy (3rd Line) CAR T-cell therapy
...

Keytruda (pembrolizumab)

Ashley S., adrenal cancer



Symptoms: Swollen ankles, very low potassium levels
Treatment:Surgery (removal of tumor, open-heart surgery); chemotherapy (EDP, Cabometyx, Carboplatin, mitotane); immunotherapy (Keytruda); radiation
...

Melinda N., Adrenal Cancer, Stage 4



Symptoms: Swelling in the face, stomach, hands, and feet, high blood pressure, acne on back and chest, itchy and tingling tongue, burning in the eyes with discharge, hair loss on the head, hair growth on upper lip and chin, bloating and stomach pain, food aversions, easy bruising, slow healing, missed periods

Treatments: Surgery to remove the tumor, chemotherapy (EDP-mitotane), radiation (SBRT), immunotherapy (Keytruda/pembrolizumab), targeted therapy (Lenvima/lenvatinib)
...

Jennifer M., melanoma



Symptoms: Night sweats, Small lump in back, similar to an insect bite
Treatment:Surgery: removal of the tumor; Radiation therapy: 20 rounds; Adjuvant immunotherapy: Keytruda
...

McKenzie E., Cervical Cancer, Stage 3C2



Symptoms: Severe abdominal & back cramping, persistent & extreme pain, heavy discharge & bleeding

Treatments: Radiation, chemotherapy (cisplatin), brachytherapy, immunotherapy (Keytruda)
...

Nick S., Colorectal Cancer, Stage 4A



Symptoms: Change in bowel habits, size & consistency, blood in stool, abdominal pain, fatigue
Treatment: Surgery (sigmoid colectomy), chemotherapy (capecitabine, oxaliplatin), immunotherapy (bevacizumab, pembrolizumab)
...

References:

• cancer.gov/about-cancer/treatment/types/immunotherapy
• https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/side-effects
• https://health.clevelandclinic.org/immunotherapy-is-it-right-for-your-cancer-type/