Immunotherapy is a form of cancer treatment that uses the immune system to attack cancer cells, in much the same way that it attacks bacteria or viruses. Rather than targeting cancer cells directly, these treatments are aimed at provoking your immune cells to recognize and destroy cancer cells.
This type of therapy seeks to harness different types of immune cells circulating in your body and has the potential to provide lasting benefits. Simply put, immunotherapy treats your body, and your body treats the cancer.
In recent years, there have been major advances in the field of cancer immunotherapy, and this treatment is currently being investigated for many cancer types.
FDA-approved immunotherapies exist for several cancers, including melanoma, lung cancer, and kidney cancer, and many more are in development. MSK patients can participate in clinical trials that give them early access to new and potentially promising immunotherapy treatments.
Types of Immunotherapy
Immunotherapy can be given in the form of drugs or as a cell-based therapy, which means that we extract and modify a patient’s own immune cells before infusing them back into the body. It is often given in combination with more conventional cancer treatments such as chemotherapy or radiation. Sometimes two immunotherapy drugs may be given together if the combination has proven more effective than one alone.
This therapy works by releasing a natural brake on your immune system so that immune cells called T cells recognize and attack tumors. These drugs target proteins on the surface of T cells that normally restrain T cells from attacking the cancer cells. By disabling the effect of these proteins, the drugs unleash your immune system to carry out the attack.
This therapy is sometimes called immune checkpoint blockade because an immune cell “checkpoint” — the protein acting as a brake — is blocked by the drug. The individual drugs are sometimes called checkpoint blockers or checkpoint inhibitors.
Our researchers have played a leading role in developing checkpoint inhibitors and demonstrating their safety and effectiveness in cancer patients.
Medical oncologist and immunologist Jedd Wolchok has helped lead several clinical trials showing that checkpoint inhibitors can be effective against melanoma and lung cancer, and these drugs are being tested at MSK against sarcoma, lymphoma, and several other cancers.
One drug called ipilimumab (Yervoy®) blocks a checkpoint protein called CTLA-4. Two additional drugs, pembrolizumab (Keytruda®) and nivolumab (Opdivo®), target another checkpoint protein called PD-1. These drugs all became available within the last few years. The US Food and Drug Administration (FDA) approved ipilimumab in 2011 and pembrolizumab and nivolumab in 2014, all for the treatment of melanoma. In 2015, the FDA also approved nivolumab and pembrolizumab for non-small cell lung cancer, and nivolumab for renal cell carcinoma.
Several additional checkpoint drugs are being studied and investigated in clinical trials at MSK.
Cell-based immunotherapy is an approach that uses your own immune cells to fight cancer, often by modifying them in some way. One type of cell-based immunotherapy showing great promise is called chimeric antigen receptor (CAR) T cell therapy, which is used to treat some types of leukemia.
Our researchers played a pioneering role in developing CAR T cell therapy and demonstrating its safety and effectiveness in patients. Michel Sadelain, Director of Memorial Sloan Kettering’s Center for Cell Engineering, medical oncologist Renier Brentjens, and Isabelle Rivière, Director of Memorial Sloan Kettering’s Cell Therapy and Cell Engineering Facility, proved that this approach can be effective against some blood cancers and are investigating its use in other cancers.
CAR T cell therapy involves removing immune cells called T cells from the blood and introducing a new gene into those cells that enables them to recognize the cancer. After the gene is inserted, the T cells are infused back into the bloodstream, where they multiply and initiate a variety of immune responses aimed at attacking the cancer cells.
CAR T cell therapy is used to treat certain kinds of blood cancer, such as B cell acute lymphoblastic leukemia (ALL). It is also being investigated for the treatment of other cancers, including some solid tumors that appear in the chest.
Conventional vaccines boost your body’s natural ability to defend against foreign invaders, like bacteria and viruses. Cancer vaccines train your body to protect itself against its own damaged or abnormal cells — including cancer cells. These vaccines expose your immune system to a protein associated with cancer that enables the immune system to recognize and destroy cancer cells with that protein.
Currently, the only FDA-approved vaccine for cancer is sipuleucel-T (Provenge®), which is used for prostate cancer that has metastasized (spread). Provenge rallies the immune system’s disease-fighting forces in men who already have prostate cancer. Provenge is created by removing some immune cells, exposing them to a protein from prostate cancer cells, and then infusing them back into the body. Provenge has been shown to extend survival in men with metastatic prostate cancer.
Although Provenge is the only FDA-approved cancer vaccine, a wide variety of vaccines are currently being investigated for use against other cancers — some of them in clinical trials at MSK.
Some conventional vaccines that prevent certain viral infections, like hepatitis B and human papillomavirus (HPV), can also be considered cancer vaccines, since they prevent infections known to cause cancer (liver cancer in the case of hepatitis B and cervical and head and neck cancers in the case of HPV).