Introduction
In the last few decades immunotherapy has become an important part of treating some types of cancer. Newer types of immune treatments are now being studied, and they’ll impact how we treat cancer in the future. Immunotherapy includes treatments that work in different ways. Some boost the body’s immune system in a very general way. Others help train the immune system to attack cancer cells specifically. Uses substances produced by the body or manufactured in a laboratory to improve or restore the function of the immune system.
Justification
The elaboration of this work is the result of the interest to know the emergence and the implementation of the immunotherapy as a new treatment for cancer. Also we want to create a disclosure material that supports the VI English program.
Theoretical framework
The purpose of the immune system is to keep infectious microorganisms, like bacterias, viruses and fungi, out of the body, and destroy this microorganisms that invade the body. The organs involved with the immune system are called the lymphoid organs, which affect growth, development, and the release of lymphocytes.
Lymphocytes are a type of infection-fighting white blood cell that are vital to an effective immune system. Although each type of lymphocyte fights infection differently, the goal of protecting the body from infection remains the same. B cells produce specific antibodies to infectious microorganisms, while T cells kill infectious microorganisms by killing the body cells that are affected. In addition, T cells release chemicals called cytokines.
Other types of white blood cells, such as phagocytes and natural killer cells, actually destroy the infectious microorganisms.
Objectives
- Emphasize the importance of the immune system.
- Publish information about a new treatment for cancer, immunotherapy.
Development
In 1995, James Allison and his technical team, detected the protein CTLA-4, which acts as a “brake” for the immune system. Meanwhile Tasuku Honjo worked at the same time from the University of Kyoto, discovered in 1992 a mechanism to decrease the action of the immune system through the protein PD-1. As result of the combination of these two discoveries, the immunotherapy was created.
Immunotherapy vs. The cancer
In the last decades the immunotherapy has become in one of the most important alternative to treat the cancer when the immune system is reactivated or stimulated to identify and defend the organism of diseases or in this case to attack and kill the cancerous cells in the organism to prevent the formation of the cancer or in other cases eliminate the cancer established in the organism.
It was demonstrated that even advanced invasive tumors may suffer a complete setback if the immune response is stimulated correctly. This opened the possibility of developing treatments against cancer through the manipulation of the immune system.
But this alternative has a some complication to fight and eliminated the cancerous cells, these complications range from the different types and locations of the cancer in the body; the level of development of cancer and mainly the predisposition of the organisms to contribute with the immunotherapy to fight against cancer. But many researches in the present are looking a many ways to solve this complications in the immunotherapy.
For example the development the alteration of the Oncolytic Viruses to use this in the organism to kill the cancerous cells and also alert the immune system to identify and attack these malignant cells or the generation or Cancer Vaccines to inject this substance in the organism in the body and stimulated the immune system to fight with a specific types of cancer such as lung cancer, cervical cancer, breast cancer, colorectal cancer, etc. These and other new ways of the immunotherapy are still in development so that in the future these will be used.
How does it work?
Tumor immunotherapy has two strategies: attacking the tumor directly or activating the immune system using cellular therapies, such as stimulation with agonists or blocking of immunologic control points. Another option against tumor is the use of gene therapy modalities, which allow the modification of gene expression for therapeutic purposes.
The immune system interacts intimately with tumors during the process of disease development and its progression to metastasis. Then the immune system responds to cancer, recognizing and eliminating abnormal cells. However, some resistant cells escape this control, decreasing their immunogenicity, promoting malignant growth. Tumor cells present changes in their surface markers.
For example, they express tumor-associated antigens (TAA) or decrease the expression of class I major histocompatibility (MHC) complex. This can trigger cells of the innate immune response, such as natural killer cells (NK). Macrophages and neutrophils attack tumor cells and stimulate cytotoxic T-lymphocytes, antigen-presenting cells and natural killers. In contrast, inflammatory cells produce tumor growth factors (TGF) and angiogenesis stimulating factors that contribute to tumor development.
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In adaptive response, processed TAA are presented by APC class I and II MHC molecules to specific receptors for CD8+ or CD4+ T cell activation, respectively. CD8+ T lymphocytes are considered the main antitumor effector cells. Once activated, they mediate the rupture of the cell membrane of the cancerous cells. On the other hand, the regulatory T lymphocytes (Treg) help to reduce inflammation. Tumor cells can secrete chemokines as CCL22 to recruit Treg cells in order to suppress the effector function of T cells and decrease the immune response.
Tumors can also deregulate if altering a complex balance between inhibitory signals (control points) and activators in different pathways that regulate the action of T cells.
Types of treatments in the immunotherapy
These are the most common types of immunotherapy treatments that are used in the actually to combat the cancerous diseases:
- Monoclonal antibodies: In this treatment is used the monoclonal antibodies that are created in a laboratory that are a many copies of antibodies with a specially work to all attack the antigen of the illness. But this process is complicated and to combat cancerous diseases.
- Cancer vaccines: It is similar to the vaccines to prevent infection and will have a healthy life, but in the cancer vaccines is used to stimulate the immune system and that this increase the response of the immune system to attack and defends against this illness or other vaccines to use in biggest infection as such The Human Papilloma Virus protects of other cancers; cervical or anal.
- Immune checkpoints inhibitors: These are drugs that stimulate the checkpoints or certain molecules with the function to activate or deactivate the immune system response; for example the drugs that target the checkpoint named PD-1 or PD-L1.
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Side effects
There are a various commonly side effects that can happen when the immunotherapy is used by patients with cancer, these are some them:
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Dangerous side effects
There are other side effects that are more dangerous for the patient and this can happen after years of the treatment is finished as sequels of the treatment, these are some them:
- Severe infection
- Skin reactions
- Hormone and gland problems
- Inflammation in zones of the brain, liver, lungs or the colon
- Vision problems
- Infusion reactions
But this side effects do not happen to all people and not all the time, depends of the organism resistance of the patients that are treating with some type of immunotherapy treatment. Therefore these side effects occurs more frequently when is used the treatment of inhibitor checkpoints.
Pros and Cons of Immunotherapy
The immune system is made up of white blood cells plus organs and tissues of the lymphatic system, such as the bone marrow. His main job is to help the body fight diseases and maintain homeostasis.Immunotherapy drugs help the immune system work more or facilitate the detection and elimination of cancer cells.Several immunotherapy drugs have been approved to fight cancer and hundreds more are being tested in clinical trials. If immunotherapy seems to be the best way to fight your cancer, your doctor may know of a clinical trial in which you can participate.
Pros:
- Immunotherapy may work when other treatments don’t, like skin cancer.
- It can help other cancer treatments work better. Other therapies you have, like chemotherapy, may work better if you also have immunotherapy.
- It causes fewer side effects than other treatments. This is because it targets just your immune system and not all the cells in your body.
- Your cancer may be less likely to return. When you have immunotherapy, your immune system learns to go after cancer cells if they ever come back. This is called immune memory, and it could help you stay cancer-free for a longer time.
Conts:
- You might have a bad reaction. The area where the medication goes into your body could hurt, itch, swell, turn red, or get sore.
- There are side effects. Some types of immunotherapy rev up your immune system and make you feel like you have the flu, complete with fever, chills, and fatigue. Others could cause problems like swelling, weight gain from extra fluids, heart palpitations, a stuffy head, and diarrhea. Most of the time, these ease up after your first treatment.
Clinical case
Judy Perkins, from Florida, had breast cancer that had spread to other organs, despite trying seven other cancer treatments. “She had tennis ball-sized lesions throughout her liver, says Steven Rosenberg at the National Institutes of Health, Maryland. “It probably would have killed her in the next two to three months.”
But Rosenberg and colleagues tried a new method for boosting the immune system to treat her cancer, and six weeks later, Perkin’s tumours had halved in size. A year later, they had disappeared. Two and a half years on from treatment, she remains healthy.
The treatment works by targeting genetic mutations that are acquired by cancer cells as they grow and multiply. These mutations are different in each patient, and some cause changes in the proteins that sit on the surface of cells. These surface proteins can be recognised by the immune system, prompting it to attack the cancer cells, but this immune reaction is usually not powerful enough to fight the cancer on its own.
Immunotherapy in Mexico.
As for our nation, the possibility that patients suffering from malignant neoplasms in different stages may benefit from pharmacological advances such as immunotherapies -with which they would achieve prolonged cancer-free remissions or longer survival than with conventional treatments- are far away for countries like Mexico, due to its high costs, said Alberto Palacios Boix, head of the immunology service at the Hospital Angeles del Pedregal.
“They are terribly expensive: they go from 15 thousand to 150 thousand dollars per year, (from 300 thousand to 3 million pesos per patient). Yes, we are facing very promising methods, but due to the price Mexico is condemned to continue treating the disease as a third world country, “said the specialist.
Conclusion
Therefore we can say that immunotherapy is an effective and considerably safe method, but it is relatively new, so there are still some years to perfect the treatment to its maximum potential, and, when that happens it is likely that the cancer could stop represent the threat that it is today.
Unfortunately, however, because of the current policy (referring to the situation in the developing countries and the price of the treatment itself), it is likely that although immunotherapy reaches its maximum potential, not everyone who needs it will have access to it.
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Image Sources:
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Immunotherapy: New tratment for cancer 