Immunotherapy for Cancer: Who Can Benefit and When Is It Used?

Cancer treatment has changed significantly over the last few years. Earlier, most people mainly knew about surgery, chemotherapy, and radiation therapy. Today, one of the most important advancements in cancer care is Immunotherapy for cancer. It has given new hope to many patients, especially in selected cancers where the immune system can be trained or activated to fight cancer cells more effectively.

What is immunotherapy?

What is immunotherapy in simple words? Immunotherapy is a type of cancer treatment that helps the body’s own immune system recognize, attack, and control cancer cells. Normally, our immune system protects us from infections and abnormal cells. But cancer cells are smart; they can hide from the immune system or switch off the immune response. Immunotherapy works by removing these “brakes” or by boosting the immune system so it can identify and destroy cancer cells better.

Unlike chemotherapy, which directly attacks rapidly dividing cells, Cancer immunotherapy treatment works through the immune system. This is why the response may sometimes take time, and the treatment is not suitable for every patient. The decision depends on the cancer type, stage, biomarkers, previous treatment history, and overall health of the patient.

How does immunotherapy work in cancer?

Cancer cells may use certain signals to escape immune attack. Some immunotherapy medicines block these escape signals and allow immune cells, especially T-cells, to attack cancer. These medicines are known as immune checkpoint inhibitors. Other forms of immunotherapy may use laboratory-made antibodies, modified immune cells, cancer vaccines, or immune-stimulating medicines.

This is why immunotherapy is often called a more “targeted” and personalized approach. But it is important to understand that immunotherapy is not a universal cure. It works very well in some patients, moderately in some, and may not work in others.

Types of immunotherapy

There are different Types of immunotherapy, and each works in a different way:

1. Immune checkpoint inhibitors
   These are among the most commonly used immunotherapy drugs. They help immune cells recognize and attack cancer cells by blocking proteins such as PD-1, PD-L1, or CTLA-4. They are used in several cancers, including lung cancer, melanoma, kidney cancer, bladder cancer, head and neck cancer, and some gastrointestinal cancers.
2. Monoclonal antibodies
   These are laboratory-made proteins designed to attach to specific targets on cancer cells. Some monoclonal antibodies directly attack cancer cells, while others help the immune system identify them.
3. CAR T-cell therapy
   In this treatment, a patient’s T-cells are collected, modified in a laboratory, and returned to the body to fight cancer. This therapy is mainly used in selected blood cancers such as certain leukemias, lymphomas, and multiple myeloma.
4. Cancer vaccines
   These vaccines are different from preventive vaccines. They are designed to help the immune system recognize cancer-related antigens and attack cancer cells.
5. Cytokines and immune modulators
   These medicines boost immune activity and may be used in selected cancers, depending on the patient’s condition and treatment plan.

Who can benefit from immunotherapy?

Not every cancer patient needs immunotherapy. It is most useful when the cancer has features that make it more visible to the immune system. Patients who may benefit include:

Patients with cancers where immunotherapy is already approved, such as lung cancer, melanoma, kidney cancer, bladder cancer, liver cancer, head and neck cancer, certain colorectal cancers, and some blood cancers.

Patients whose tumor shows specific biomarkers such as PD-L1 expression, MSI-H, dMMR, high tumor mutational burden, or other molecular markers. These tests help oncologists understand whether immunotherapy may work better.

Patients with advanced or metastatic cancer where immunotherapy has shown benefit as a first-line or later-line treatment.

Patients in whom cancer has returned after previous treatment and immunotherapy is a suitable option based on cancer type and test results.

In some cancers, immunotherapy may be combined with chemotherapy, targeted therapy, or radiation to improve results. Cancer.Net notes that modern cancer treatment planning depends on cancer type, stage, overall health, treatment goals, and specific cancer features.

When is immunotherapy used?

Immunotherapy may be used at different stages of cancer treatment:

In advanced cancer: Many patients receive immunotherapy when cancer has spread or cannot be removed completely by surgery.

After surgery: In some cancers, immunotherapy may be given after surgery to reduce the risk of recurrence.

Before surgery: In selected cases, immunotherapy may be given before surgery to shrink the tumor.

With chemotherapy: In several cancers, immunotherapy is combined with chemotherapy to improve treatment response.

When cancer comes back: If cancer returns after earlier treatment, immunotherapy may be considered depending on the cancer type and biomarkers.

The timing of immunotherapy should always be decided by a medical oncologist after reviewing biopsy reports, scans, molecular tests, previous treatment, and the patient’s general condition.

Immunotherapy benefits

The major Immunotherapy benefits include the possibility of a long-lasting response in selected patients. Some patients continue to benefit even after treatment is stopped because the immune system may remember cancer cells. Immunotherapy can also be useful in cancers where chemotherapy alone may have limited results.

Another benefit is that immunotherapy does not work like traditional chemotherapy. It usually does not cause hair fall or severe nausea in the same way chemotherapy can, though side effects can still occur. The quality of life may be better for some patients, depending on the treatment and response.

Are there side effects of immunotherapy?

Yes. Immunotherapy can cause side effects because an activated immune system may sometimes attack normal organs. These are called immune-related side effects. They can affect the skin, lungs, liver, thyroid, intestine, joints, or other organs. Symptoms may include rash, loose motions, cough, breathlessness, fatigue, fever, thyroid imbalance, or liver enzyme changes.

The most important thing is early reporting. If side effects are detected early, they can often be managed effectively. Patients should never ignore new symptoms during immunotherapy.

Why expert guidance is important

Immunotherapy is a powerful treatment, but it must be used carefully. The right patient selection is the key. Before starting treatment, an oncologist may advise tests such as biopsy review, immunohistochemistry, PD-L1 testing, MSI/MMR testing, next-generation sequencing, blood tests, and scans.

Dr. Vikas Goswami, Senior Medical Oncologist, focuses on evidence-based cancer treatment planning where every treatment decision is personalized according to the patient’s diagnosis, stage, biomarkers, and overall health. Immunotherapy should never be started only because it is a “new” treatment. It should be started when there is a clear medical reason and expected benefit.

Final thoughts

Immunotherapy for cancer has changed the treatment journey for many patients, but it is not suitable for everyone. The right approach is to understand the cancer type, stage, biomarker status, and available treatment options. With proper evaluation and expert oncology guidance, immunotherapy can become an important part of a patient’s cancer treatment plan.

Disclaimer: This blog is for awareness only and should not be considered a substitute for medical consultation. Cancer treatment decisions should always be made after consultation with a qualified medical oncologist.