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The concept of immunotherapy has been around for ages. A century ago, a physician known as William Coley noted that some patients, when infected with a bacterium, appeared to fight off their cancers. The theory behind immunotherapy is that your immune system already knows how to fight cancer.
Cancer cells may be marked as unusual and destroyed by the immune system, much as your body can identify, label, and mount an immune response against bacteria and viruses that enter it. On the other hand, Cancers may occasionally outwit the immune system and defend themselves; this is the premise of immunotherapy. It really aids in the body’s immune system recognizing and attacking cancer cells.
While there are many distinct types of immune cells and biochemical processes that culminate in the elimination of cancer cells, T-cells (T lymphocytes) and natural killer cells are the “big guns” in attacking cancer cells (NK cells). Immunotherapy works either directly or indirectly to increase the activity of these cells, which then fight cancer cells.
Types Of Immunotherapy
Immunotherapy has long been utilised in cancer treatment, with the BCG vaccination being used as part of local therapy for urinary bladder cancer. Immunotherapy treatments function in various ways. Some immunotherapy therapies assist the immune system in stopping or slowing cancer cell development. Others aid the immune system in the destruction of cancer cells or prevent cancer from spreading to other regions of the body.
Immunotherapy therapies can be used on their own or in conjunction with other cancer treatments. Non-specific immunotherapies, such as interferon and interleukins, have been used to treat various malignancies, including urinary bladder cancer, multiple myeloma, blood cancers, and others.
Immune checkpoint inhibitors are another type of immunotherapy that is often used in many tumour sites (ICI). It all started in the early 2000s with the launch of Ipilimumab, a drug that targeted the CTLA-4 pathway in diseases like Malignant Melanoma. Later, ICI, known as PD-1 Inhibitors, such as Pembrolizumab and Nivolumab, were developed and used in lung tumours and other sites.
Other medications, such as PDL-1 inhibitors, of which Atezolizumab is a prototype, have recently hit the market. These were first used to treat metastatic disease. However, their effectiveness in curative circumstances has been proven.
Immune checkpoint inhibitors are the only Immunotherapies that are commonly used to treat cancer. Oncolytic Virus treatment and CAR-T therapy are two more forms of immunotherapies that have been authorised for use in certain cancers.
Objectives Of Immunotherapy
Immunotherapy is being widely researched, and within the next decade or two, every cancer patient will be treated with medications that boost their immune responses, in combination with standard medicine if necessary.
However, there is currently very little evidence on the efficacy and tolerance of these new medicines in the Pakistani population. Our food and the bacteria that reside in our intestines have a large influence on our immune system.
The objective of using more immune-boosting medicines is to make malignancies less lethal and maybe even allow cancer lesions to be completely managed by the patient’s own immune system by making them chronic rather than fatal.
Immunotherapy has fewer acute adverse effects than standard cancer treatments such as chemotherapy and radiation. However, immunotherapy has its own set of immune-related adverse effects that are typically treated with steroids.
Because smokers have mutations in tumour cells, checkpoint blockade treatments are highly effective in treating head and neck and lung malignancies. Aside from lung cancer, melanoma, lymphomas, and solid tumours can all be treated. These treatments have also advanced to the forefront of treatment for liver cancer.
The European Society for Medical Oncology (ESMO) has revealed the first small immunotherapy success against triple-negative breast cancer, a terribly aggressive disease that predominantly affects younger women and has persistently defied prior treatment choices.
The Oncology department of Dr Ziauddin Hospital, North Nazimabad, was Karachi’s first private oncology centre, opening in 1997. We then built our cutting-edge Cancer Centre and Radiotherapy department in 2014, after which we began all contemporary therapies such as immunotherapy and radiation treatments such as 3D-CRT and IMRT.
Now there are many oncologists practicing in Karachi and you can get in touch with ’em through Marham.pk.
Immunotherapy, such as Nivolumab, and other targeted treatments were utilised for various indications, including lung cancer, kidney cancer, head and neck cancer, uterine sarcoma, and Hodgkin’s lymphoma.
Furthermore, with the approval of Immunotherapy in Triple-negative breast cancer, we started Atezolizumab in these patients. We are delighted to inform you that two of our patients who have been on immunotherapy for two years have been certified disease-free (Complete Clinical Response) following a response review with PET imaging.
We are now accepting patients with the particular necessity of immunotherapy, and we serve around 4-5 immunotherapy patients each month.
Dr Shabbir Hussain
Consultant Clinical Oncologist
Ziauddin University Hospital
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