Immunotherapy
Our immune systems normally provide effective protection of our bodies against diseases. Our biological defence system is usually strong enough to fight and destroy pathogens.
Immunotherapy refers to a series of relatively new methods for treating chronic inflammatory diseases, and is mostly used when the patient’s immune system fails. This is caused by a variety of factors. For example, the body’s defence system can sometimes be too weak to find and destroy harmful cells. Due to genetic modifications, tumour cells in particular can ensure that pathological changes are either not detected at all or that the immune system is actively suppressed.
This is where immunotherapy comes in. The aim of these treatments is to influence the immune system in a targeted manner depending on the corresponding disease.
This form of treatment is becoming increasingly important in treating cancer, not least because immunotherapy can be less harmful to patients than conventional types of treatment. An increasing number of treatment options are also becoming available for treating chronic inflammatory diseases and autoimmune diseases, as well as after organ transplants.
You will find answers to the most frequently asked questions about immunotherapy below.
What is Immunotherapy?
Immunotherapy refers to a series of relatively new drug-based therapies that are used to treat chronic inflammatory diseases and cancer. Mostly, immunotherapy involves administering proteins (generally antibodies) to patients, which either neutralise inflammatory messenger substances or bind to cells to inhibit or activate them, depending on the disease in question. The most recent development in immunotherapy is the administration of genetically modified cells.
The medication is usually given as tablets or intravenously. How the medication is administered, that is, if patients can inject the medication themselves or have to receive treatment in outpatient clinics depends on the type of immunotherapy involved.
Types of Immunotherapy
The different methods of immunotherapy are classified according to the approach on which they are based.
Several types of immunotherapy involve inhibiting inflammatory messenger substances that cause inflammation in the body. These types of immunotherapy are used mainly to treat rheumatic diseases, inflammatory bowel conditions and skin conditions. One example are substances known as cytokine inhibitors.
Other types of immunotherapy target the overreacting immune cells in the organism and either inhibit or promote their activity. Inhibiting therapies include antibodies that are used to inhibit overreacting immune cells such as B cells in autoimmune diseases or lymphoma. Activating antibody therapies, on the other hand, stimulate the immune cells in order to kill off tumour cells. These types of therapies are also known as checkpoint inhibitors.
Another relatively new example of immunotherapy involves cells known as CAR-T cells. The first step of this treatment involves removing T cells from the blood of patients suffering from cancer or chronic inflammatory diseases such as lupus erythematosus. These cells are genetically modified before being reintroduced to the patient intravenously. The manipulated T cells can then attack cancer cells and other diseased cells.
How long does it take for treatment to take effect?
The speed at which treatment is effective depends on the disease and the type of immunotherapy being used.
How effective is immunotherapy?
Not all patients respond well to treatment. Some patients experience a reduction in the effectiveness of the therapeutic agent during the course of treatment. It is therefore essential that the doctors administering the treatment draw up an individual treatment concept tailored to the patient and monitor progress carefully. In some cases, conventional types of treatment such as surgery, radiation or chemotherapy are combined with immunotherapy.
A patient’s suitability for treatment with immunotherapy depends on several factors and must be decided on a case by case basis. These factors include the stage of the disease, its biomarkers, any previous courses of treatment and the patient’s general health.
Which side effects are possible with immunotherapy?
Various side effects are possible with immunotherapy, depending on the type of immunotherapy being given.
Treatments that suppress the immune system, which are used in inflammatory diseases, are usually extremely safe and only lead to a slightly increased tendency for infections that is, however, low compared with that of medication such as cortisone.
Treatments that stimulate the immune system and are used to treat tumours can lead to inflammation of the skin, bowels, lungs, liver and endocrine organs such as the pituitary gland or thyroid.
Future Developments
The DZI is currently conducting research into how the early use and combination of various treatments can improve the effectiveness of immunotherapy. Current research and development at the German Centre for Immunotherapy (DZI) also focuses on increasing the specificity of immunotherapy based on biomarkers. Finally, research at the Centre aims to ensure the safety of immunotherapy and the effectiveness of combination therapies. For this purpose, methods of immunotherapy that have not yet been approved are currently only administered under controlled conditions in clinical trials. The decision as to whether a patient meets the specific requirements has to be made on a case by case basis.
