When thinking about cancer treatment, the first methods that usually come to mind are chemotherapy and radiation therapy. However, there are innovative alternatives to combat this disease, such as immunotherapy: a set of new generation treatments designed to stimulate the body’s natural defenses and enhance the immune system response.
This therapy can be applied to some solid tumors or hematological cancers, such as leukemia. However, in most cases it is applied when traditional treatments, such as chemotherapy or radiotherapy, do not work. Dr. Sergio Navarro, immunologist at the Hospital Clinic Barcelonawarns that not all patients can receive this treatment: “They must meet a series of requirements to be able to enter this clinical trial.”
The ability of the immune system to act against cancer cells has been the subject of scientific debate. However, there is currently consensus that the immune system responds to cancer when danger signals produced by tumor cells are detected. This process triggers an adaptive response, mediated by T lymphocytes, responsible for identifying and attacking malignant cells. For Dr. Daniel Benítez, immunology specialist at Hospital Clínic Barcelona, “immunotherapy is the therapy of the future.”
Immunotherapy is the therapy of the future
What types of immunotherapy exist?
There are different types of immunotherapy and some can be combined with each other. The most common ones use antibodies with various functions: blocking tumor growth, inducing the death of cancer cells, preventing the deactivation of T lymphocytes or being immunostimulant. On the other hand, non-specific immunotherapies strengthen the immune system to attack cancer cells and are often used together with chemotherapy or radiotherapy, or as a follow-up treatment.
Another way to attack these malignant cells is the use of oncolytic viruses, modified in the laboratory to attack only cancer cells without damaging healthy ones. There are also dendritic cell vaccines, designed to stimulate the immune system. However, the most innovative therapy is based on T cells. This approach is divided into three types: tTCR, CART and TILS. The last two are the most used and require the extraction of the patient’s T lymphocytes to modify them and reintroduce them later.
In the CART therapythe patient’s T lymphocytes are genetically modified to provide them with anti-tumor capacity. The procedure begins with a blood draw, which is processed in a specialized device to separate the T lymphocytes from the rest of the cells. Once modified in the laboratory, these lymphocytes reproduce until they reach the amount necessary to guarantee the effectiveness of the treatment. Finally, they are infused back into the patient.
The lymphocyte production process usually lasts between 7 and 12 days, while the administration is carried out in sessions of 15 to 30 minutes. The therapy is divided into three or four doses, spaced between one and three days, so that the patient completes the treatment in approximately one week.
The TIL therapy It works in a slightly different way. First of all, it requires a biopsy to obtain the lymphocytes found in the tumor, called infiltrating lymphocytes. If these lymphocytes are inactive or in small numbers, they are not able to eliminate tumor cells, allowing the tumor to continue growing.
The goal of therapy is to recover the functionality of these cells. To do this, fragments of the biopsy are extracted and cultured in the laboratory to select the most effective lymphocytes. These lymphocytes multiply for two weeks and are then reintroduced into the patient. The final dose is frozen in three 120 mL bags and administered in a single day, making the process a relatively quick intervention.
The home infusion program minimizes the patient’s contact with the hospital environment and, above all, improves their quality of life.
What advantages does home infusion have?
One of the innovations that has facilitated treatment is home infusion, which allows a health professional to go to the patient’s home to perform the necessary tests, complete a symptom questionnaire prior to the medical consultation, and subsequently apply the treatment. In this way, the treatment significantly reduces the number of hospital visits. According to Dr. Javier Marco, a specialist in the Internal Medicine Service at Hospital Clínic Barcelona, this modality “minimizes the patient’s contact with the hospital environment and, above all, improves their quality of life.” In addition, it represents an advantage for both the patient’s family and those who care for them.
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