Cancer immunotherapies help direct and strengthen the immune system’s response to cancer. Some types of immunotherapy have been approved to treat lymphoma, a cancer of the lymphatic system. The two main types of lymphoma are Hodgkin lymphoma (about 10 percent of cases) and non-Hodgkin lymphoma (about 90 percent of cases).
Optimal immunotherapies for lymphoma depend on many factors, such as the type of lymphoma diagnosed, stage of disease, and a person’s age and overall health. Immunotherapies that are effective at treating one type of lymphoma may not treat others as well.
Immunotherapy works by teaching the natural immune system to fight cancer cells better. Immunotherapy can help the immune system by:
This type of treatment has many benefits. First, by harnessing the immune system, these treatments — unlike others — can tell the difference between healthy cells and lymphoma cells. Second, immune cells can adapt to continually attack cancer cells even after many medications stop working. Finally, the immune system remembers what cancer cells look like, so it can target and kill cancer cells more effectively if they try to return later.
A combination of chemotherapy and radiation therapy is typically used to treat lymphoma, but the use of immunotherapy drugs is on the rise. Immunotherapy has improved the quality of life and overall survival for adults and children living with lymphoma. There are several immunotherapy treatments approved by the U.S. Food and Drug Administration for lymphoma.
Targeted antibodies are designed to affect one or more specific immune pathways. The immune system naturally produces trillions of different types of antibodies to fight infections and cancer. Scientists have learned how to manufacture some of the antibodies that are most effective at fighting cancer.
Targeted antibodies include monoclonal antibodies (which target one specific pathway, such as the cells’ ability to grow) and antibody-drug conjugates (an anticancer drug combined with an antibody to deliver the drug specifically to cancer cells).
Antibody-drug conjugates include:
Monoclonal antibodies include:
Immunomodulators work to stimulate or suppress the immune system. Examples of immunomodulators include vaccines, checkpoint inhibitors, and cytokines. Checkpoint inhibitors help T cells (a type of white blood cell in the immune system that protects against infection and cancer) kill cancerous cells. Cells of the immune system use cytokines to communicate and interact with other cells.
Adoptive cell therapies involve removing T cells from a person’s blood, growing them in a laboratory, and then giving the T cells back to the person so the extra cells can fight cancer. Chimeric antigen receptor (CAR) T-cell therapy is a type of adoptive cell therapy. In CAR T-cell therapy, the T cells are taught how to better attack and kill cancer cells in the laboratory before they’re given back to the person with lymphoma.
Adoptive cell therapies include:
See what Dr. Matt Kalaycio says about the uses of CAR-T therapies.
Like many cancer treatments, immunotherapy may work better for some people than for others. Side effects of immunotherapy tend to be different from typical cancer treatment side effects. They are usually caused by stimulation of the immune system. Common side effects are usually minor, such as:
However, life-threatening side effects have also been reported. Oncologists and researchers are working to better understand the risk factors for severe immunotherapy side effects.
There are ongoing clinical trials to test new types of immunotherapy. Many immunotherapies that haven’t been approved specifically to fight lymphoma are still available through these trials. Several immunotherapies currently in clinical trials for lymphoma treatment in adults or children look promising.
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