How has the development of immunotherapy revolutionised cancer treatment and cancer patient care?

The last decade has witnessed momentous advances in cancer treatment, more specifically, the emergence of immunotherapy. It was awarded as the Breakthrough of the Year in Science in 2013.1 The survival benefit achieved with the use of immunotherapy in comparison to standard treatment, chemotherapy for instance, as well as its manageable toxicity profile, has revolutionised cancer therapy.2

Immunotherapy originated in 1891 with a cancer surgeon named Dr. William B. Coley. He observed that, through attempting to treat inoperable bone sarcoma by causing erysipelas and subsequently stimulating the immune system, infecting a cancer patient with streptococcal organisms resulted in significant tumour regression and even the rare occurrence of spontaneous remission (~1 in 60,000-100,000 cancer patients worldwide).3 Despite having successful results, his work was often severely criticised and occasionally entirely dismissed. It was not until the twentieth century when appeal in the immune system resurfaced, with many advances in cancer research such as the first ever cancer vaccine, discovered by Ruth and John Graham in 1959.

Immunotherapy serves two purposes: to stimulate the immune system’s natural defences in being more efficient in attacking cancer cells and to re-establish or improve the function of the immune system, hence assisting the process of identifying and eradicating abnormal cells. Immune checkpoint inhibitors, a notable development in anti-cancer immunotherapy, reinitiates T cell proliferation and cytokine secretion, culminating in enhanced tumour immunosurveillance.4 Within the immune system, immune checkpoint proteins activate once foreign cells are detected, triggering an immune response to destroy the foreign cells. Withal, the selective pressure of CD8+ T lymphocytes on cancer cells leads to “immunoediting”,5 i.e., the cancer cells are no longer effectively recognised due to possessing a lack of tumour antigens, thus deactivates immune checkpoint proteins and evades attack by the immune system. Immune checkpoint inhibitors, e.g. tumour-associated macrophages, interfere with this co-inhibitory pathway.

In recent years, immunotherapy has become a fundamental treatment modality in treating certain types of cancer that have been resistant to other cancer therapies, metastatic melanoma for instance. Immunotherapy targets cancer cells specifically, unlike traditional chemotherapy, which cannot differentiate between normal host cells and cancer cells, therefore targeting DNA and proteins expression in both types of cells. As a result, the side effects of immunotherapy are commonly minimal and less severe, indicating the reduction of hospitalisation and the delivery of the treatment in the patient’s own residence. Due to this, immunotherapy has set a new standard of cancer patient care, particularly for those with advanced cancers.

Advancements in cancer immunology is rapidly progressing. The implementation of immunotherapy will continue to shape the personalisation of cancer care as more is discovered about how this agent is utilised, along with how it enhances other systemic anti-cancer therapy treatments. Possibilities for further innovation involving immunotherapy has sparked a promise to completely transform cancer therapy.

Footnotes:

1J. Couzin-Frankel “Cancer Immunotherapy” Science 2013; 342(6165): 1432-1433. https://www.science.org/doi/full/10.1126/science.342.6165.1432

2J. Raphael et al. “Utilization of Immunotherapy in Patients with Cancer Treated in Routine Care Settings: A Population-Based Study Using Health Administrative Data” NIH (National Library of Medicine) 2022 Aug;27(8):675-684. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355820/#r1title

3E.F. McCarthy “The Toxins of William B. Coley and the Treatment of Bone and Soft-Tissue Sarcomas” NIH (National Library of Medicine) 2006;26:153-158 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355820/#s5title

4G. Kroemer et al. “Immune checkpoint inhibitors” JIH (Journal of Experimental Medicine) 2021;218(3):e20201979 https://rupress.org/jem/article/218/3/e20201979/211804/Immune-checkpointinhibitorsImmune-checkpoint

5Ibid.

Business Management

In-person

Cultivate leadership skills in New York, where multinational...

Career Insights
Provides a comprehensive introduction to various professions. Suitable for students starting to consider their future careers and wishing to explore different professions.
Laptop with Google analytics dashboard on screen
Ages: 15-18

Coding

In-person

Master the language of technology in Cambridge, a...

Academic Insights
Provides a thorough introduction to diverse academic fields. Ideal for students beginning to contemplate their future academic paths and eager to explore various disciplines.
A laptop that shows programming codes.
Ages: 16-18

Why Apply To The Immerse Education Essay Competition?

Are you a highly motivated student aged 13-18? Have you ever wanted to experience studying at one of the world’s top universities?

The Immerse Education essay competition allows you the chance to submit an essay for the chance to be awarded a scholarship to attend one of our award-winning academic or career-based summer schools.

Join the Immerse Education 2024 
Essay Competition

The Immerse Essay Competition is open for 2024! Follow the instructions to write and submit your best essay for a chance to be awarded a 100% scholarship.

Join competition

How To Apply To The Immerse Education Essay Competition

If you’re aged 13-18 and interested in applying to the Immerse Education essay competition, please visit our essay competition page for more details.