What is immunotherapy?
The body’s immune system is a complex defense network made up of white blood cells and various organs and tissues with the purpose of protecting the body against harmful substances, like infections, germs, and diseases. Immunotherapy, also referred to as biological therapy, is a disease treatment that boosts this immune system's functionality, enhancing the body's ability to recognize and eliminate diseased cells, like cancer cells.
Immunotherapy is primarily used to treat cancer by detecting and attacking cancerous cells to be destroyed, effectively removing the cancer from the body. However, this treatment method may be used for other conditions, including:
- Allergic reactions: To desensitize the body when the immune system overreacts to harmless substances
- Autoimmune diseases: To correct the immune response when the immune system attacks the body’s own tissues in conditions like rheumatoid arthritis, inflammatory bowel disease, and psoriasis
- Transplant rejection: To help the body accept a transplanted organ or tissue when the immune system views it as foreign and attacks it
- Inflammatory disorders: To reduce inflammation in conditions like lupus, where the immune system causes harmful levels of inflammation
- Infectious diseases: To boost the immune response to fight infections like tuberculosis, malaria, Zika virus, and COVID-19
How immunotherapy works
Immunotherapy enhances the immune system’s natural ability to detect and eliminate abnormal cells. This has become an important treatment option for cancer because cancer cells can evade the immune system through genetic changes that make them less detectable by expressing proteins that inhibit immune responses or by altering surrounding normal cells to interfere with the immune response. By boosting the immune system’s effectiveness, immunotherapy helps overcome the evasive nature of cancer cells, improving the body’s ability to get rid of the disease. In other conditions, immunotherapy works by either stimulating the immune system to work harder or smarter against diseases, or by calming it down when it is overactive.
While immunotherapy has shown great effectiveness for treating specific types of cancer, ongoing research and clinical trials for cancer care at Penn Medicine are broadening its potential applications to treat more cancers and other chronic conditions.
Types of immunotherapies
There are various types of immunotherapies that assist the immune system in detecting and eliminating cancer in different ways. Penn Medicine offers a range of immunotherapies, including targeted molecular therapy, vaccine therapy, and the treatment our scientists pioneered, CAR T cell therapy.
CAR T cell therapy is a groundbreaking treatment that involves reprogramming your immune cells to identify and remove cancer cells. This therapy begins by removing T cells (a type of white blood cell) from your body. The T cells are then modified in a lab to recognize the specific markers of cancer cells. After they’ve been modified, the cells are reintroduced into your body, where they can then target and eliminate the cancer cells. First developed by Penn Medicine, CAR T cell therapy has led to FDA-approved treatments for lymphoma and leukemia and holds promise for other cancers, like glioblastoma.
Targeted molecular therapy, or just targeted therapy, helps the immune system distinguish between healthy cells and cancer cells. The treatment then disables the cancer cells, making it easier for the immune system to manage them. This approach has been effective in treating cancers like melanoma and lung cancer and is being explored for other cancer types, including ovarian cancer.
Vaccine therapy is an immunotherapy that prevents or treats cancer by stimulating the immune system to recognize and eradicate cancer cells. We use vaccine therapy to treat various cancer types, including mesothelioma, prostate cancer, and breast cancer. Current research is focused on developing vaccines for pancreatic cancer, lung cancer, head and neck cancers, and recurrent breast cancer, with the goal of either curing the disease or preventing it from developing.
Penn Medicine offers additional immunotherapies that enhance the immune system’s response to cancer, including checkpoint inhibitors, adoptive cellular therapy, monoclonal antibodies, and cytokine therapy. Some immunotherapies are more effective for certain types of cancer. Your doctor may recommend multiple immunotherapy types or a combination of immunotherapy with other treatments like chemotherapy to improve your outcome. Ongoing studies at Penn Medicine aim to discover new immunotherapy techniques and enhance existing ones to treat a broader range of cancers and other chronic conditions. Your doctor will discuss your condition and medical history to determine which immunotherapies might be right for
Eligibility for immunotherapy as a treatment
The decision to use immunotherapy is made on a case-by-case basis by Penn Medicine doctors. Patients who are considered good candidates for immunotherapy are those who are likely to gain more benefit from immunotherapy compared to other treatments, considering the effectiveness, potential side effects, and any impact on their quality of life.
For cancers that are resistant to conventional treatments, immunotherapy offers an alternative method to target and eliminate cancer cells. Immunotherapy may also be appropriate for patients with conditions other than cancer. Your Penn Medicine care team will advise you on whether immunotherapy might be an effective treatment option for you. Your doctor may recommend immunotherapy if:
- You have a cancer type that is resistant to standard treatments like chemotherapy or radiation. These cancers may grow too quickly for conventional therapies to be effective.
- You have a cancer type that has developed resistance to multiple drugs. Even if a cancer initially responds to standard treatments, it can become resistant over time, especially if initial treatments do not fully eliminate the tumor.
- You have a condition other than cancer that is impacting your immune system’s response.
What is the process for receiving immunotherapy?
Immunotherapy is typically administered through an intravenous (IV) infusion, though other forms are available. The timing of treatments varies. Immunotherapy may be given daily, weekly, monthly, or in cycles, with rest periods in between to allow the body to recover and produce healthy cells. The duration of treatment depends on several factors, including the type and stage of cancer, the specific immunotherapy drug used, and the patient’s response to the treatment.
Immunotherapy can be delivered in various forms, including:
- Intravenous (IV): Administered directly into a vein
- Oral: Taken as pills or capsules
- Topical: Applied as a cream to the skin
- Intravesical: Delivered directly into the bladder
Recovery after immunotherapy
Recovery from immunotherapy involves a significant amount of careful monitoring by your doctors. They will watch closely for any side effects and check regularly for signs that the treatment is achieving the desired result. This observation period is crucial because the immune system can respond in unpredictable ways, and side effects can vary from mild to severe. Depending on how your immune system responds, your doctor may need to adjust your treatment. The recovery process can take weeks or months, as the immune system gradually adjusts, and the effects of the therapy become more apparent. During this time, frequent follow-ups and tests are essential to ensure the best possible outcome and manage potential complications.
Side effects of immunotherapy
The side effects of immunotherapy can vary significantly among patients. Since immunotherapy stimulates the immune system to target diseased cells, it can sometimes target healthy cells as well, leading to certain side effects. The likelihood and severity of side effects depend on factors such as a patient’s overall health, the type and stage of cancer or other condition, and the specific immunotherapy and dosage used. There is no set timeline for when side effects might appear, either during or after treatment. Severe allergic and inflammation-related reactions are rare but can occur with some types of immunotherapies.
Your Penn Medicine care team will be there to support you throughout the entire treatment process, to help you understand what to expect and manage any symptoms.
Some common side effects include:
- Chills
- Constipation or diarrhea
- Coughing
- Appetite changes
- Fatigue
- Fever
- Injection site reactions, like pain or swelling
- Nausea
- Weight loss
State-of-the-art immunotherapy at Penn Medicine
The groundwork for immunotherapy for cancer began in 2003 with the mapping of the human genome. For the first time, researchers knew which genes affected which traits in the body. But changing those genes to improve health would require more. Over the next decade, Penn Medicine built on this knowledge, creating the first FDA-approved immunotherapy, called CAR T cell therapy. Penn Medicine has used this groundbreaking technique for retraining the body’s T cells to treat hundreds of patients with cancer. Today, our pioneering researchers are developing new immunotherapies to treat cancer, as well as other diseases, including multiple sclerosis (MS), Parkinson’s disease, Alzheimer’s disease, infectious diseases, and more.
Patients receiving immunotherapy at Penn Medicine benefit from the expertise and experience of providers who have been researching and administering immunotherapy since its inception. With access to the most advanced immunotherapy approaches and ongoing clinical trials for new treatments, our patients experience improved outcomes and better quality of life.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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Patient stories
From survivor to inspiring others to exercise
Doris Piccinin uses her own firsthand experience as a breast cancer survivors to help other survivors. “I’m excited to see a lightbulb go on for people when they realize that not all physical activity is the same, and to see them recognize and understand the questions to ask when they’re having limitations. That’s where I gain my inspiration.”
An unexpected ovarian cancer diagnosis
“I’m thankful for the support and many prayers from my family and friends. I appreciate that I received care close to home and grateful that Dr. Soriano found my cancer,” said Donna Frandsen.
Genetic knowledge helps catch cancer early
“I didn’t know about BRCA at all before my sister’s diagnosis—it was a total learning curve,” Trudy Orthey said. “If you know that your family carries this gene mutation, don’t be afraid to talk about it. I did and it saved my life. It also has a ripple effect to your family and future generations.”
A five-time survivor who keeps fighting follicular lymphoma
“I have been truly thankful for the medical expertise and personal care I have and continue to receive at Penn Medicine while managing this cancer that continues throughout my life,” said Sharon Dunkel.
A mom-inspired clinical trial journey to help others
“I wanted to participate in a clinical trial because I was inspired by my mom,” Kate Korson said. “I saw how brave she was and the success she had on a clinical trial. I felt like I received the best possible care by taking part in a clinical trial, and it feels good to know that I’m helping others by contributing to cancer research.”
Coming home to ‘Team Penn’: Kate’s Story
From the moment Kate Korson showed up at her first appointment wearing a Penn sweatshirt to symbolize she was on “Team Penn,” every one of her caregivers let her know they were on “Team Kate.” “Penn has now saved all three members of my family,” she said, after participating in a clinical trial.
Competitive weightlifter takes on rare blood cancer
“I knew the downside—cancer winning this battle,” said Howard Aaron. “But for any competition I’ve competed in, I’ve adapted a method of mental, emotional, and psychological preparation to handle it. I took on this cancer as if it was another competition.”
Creating beauty out of a breast cancer journey
“Cancer isn’t just physically grueling. It mentally and emotionally tears you down,” Ginger Mimmo Rohlfing said of her experience navigating HER2-positive breast cancer, chemotherapy, mastectomy, and breast reconstruction surgery. Her paintings of leaf and petal patterns “were a metaphor for putting pieces of myself back together.”
First-ever CAR T cell patient who lived beyond hope
“I’m looking for [extending life by] a day, a week, or a month, and here they are telling me I don't have cancer,” said Bill Ludwig, years later. “It was just like someone told you, ‘You won the lottery.’”
A diagnosis that ripples through the family
“It’s harder to find out your sister has cancer and a BRCA mutation than to find out for yourself,” said Laura Temple. Testing and treatment have made all the difference for the three BRCA-positive sisters who are now breast cancer survivors. They are grateful for Susan Domchek, MD, answering questions about research that could benefit their children.