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

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. 

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. 

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 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. 

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.