Immunotherapy​ ​--​ ​A​ ​More​ ​Feasible​ ​Solution​ ​to​ ​Combat​ ​Cancer?!

By:​ ​Thomas​ ​Cava

Conducted​ ​Under​ ​Laura​ ​Cava​ ​(current​ ​Physician​ ​Assistant)
Composed​ ​throughout​ ​Summer​ ​17’

WHAT​ ​EXACTLY​ ​IS​ ​IMMUNOTHERAPY?

● Immunotherapy​:​ ​one​ ​of​ ​various​ ​cancer​ ​treatments​ ​that​ ​assists​ ​one’s​ ​immune​ ​system​ ​in
combating​ ​cancer
○ More​ ​specifically,​ ​it​ ​is​ ​a​ ​particular​ ​type​ ​of​ ​biological​ ​therapy​​ ​(a​ ​type​ ​of​ ​therapy
that​ ​uses​ ​substances​ ​made​ ​from​ ​living​ ​organisms​ ​to​ ​treat​ ​cancer)
○ As​ ​part​ ​of​ ​its​ ​therapeutic​ ​process,​ ​immunotherapy​ ​often​ ​uses​ ​substances​ ​dubbed
biological​ ​response​ ​modifiers​ ​(BRM’s)
■ The​ ​body​ ​normally​ ​produces​ ​miniscule​ ​amounts​ ​of​ ​BRMs​ ​in​ ​response
to​ ​an​ ​infection​ ​or​ ​disease;​ ​however,​ ​when​ ​in​ ​a​ ​laboratory,​ ​a
substantial​ ​amount​ ​of​ ​BRMs​ ​can​ ​be​ ​generated​ ​as​ ​a​ ​remedy​ ​for​ ​cancer
or​ ​other​ ​illnesses
● Immunotherapy​ ​isn’t​ ​necessarily​ ​a​ ​more​ ​modern​ ​concept..​it​ ​was​ ​first​ ​useful​ ​in​ ​the​ ​late
19th​ ​century​ ​when​ ​William​ ​Coley​ ​injected​ ​mixtures​ ​of​ ​live​ ​Streptococcus​ ​pyogenes
and​ ​Serratia​ ​marcescens​ ​into​ ​patients’​ ​tumors​ ​in​ ​1891
○ William​ ​Coley​ ​was​ ​deemed​ ​the​ ​“father​ ​of​ ​immunotherapy”
○ What​ ​many​ ​people​ ​don’t​ ​fathom​ ​is​ ​that​ ​immunotherapy​ ​has​ ​been​ ​around​ ​for​ ​quite
a​ ​few​ ​centuries​ ​and​ ​that​ ​it​ ​was​ ​actually​ ​the​ ​first​ ​nonsurgical​ ​treatment​ ​for​ ​cancer
■ Its​ ​birthplace​ ​is​ ​Memorial​ ​Sloan​ ​Kettering​ ​Cancer​ ​Center​ ​(located​ ​in
○ However,​ ​more​ ​common​ ​treatments​ ​of​ ​cancer​ ​such​ ​as​ ​chemotherapy​ ​and​ ​radiation
have​ ​taken​ ​precedence​ ​in​ ​today’s​ ​society
■ This​ ​was​ ​due​ ​to​ ​the​ ​fact​ ​that​ ​there​ ​was​ ​a​ ​dearth​ ​of​ ​knowledge​ ​concerning
the​ ​mechanisms​ ​of​ ​different​ ​types​ ​of​ ​immunotherapies..hence​ ​the​ ​notion
of​ ​deliberately​ ​injecting​ ​patients​ ​with​ ​bacteria​ ​resulted​ ​in​ ​surgeons​ ​and
oncologists​ ​to​ ​adopt​ ​the​ ​ideas​ ​of​ ​surgery,​ ​chemotherapy,​ ​etc​ ​as​ ​standard
treatments​ ​early​ ​in​ ​the​ ​20th​ ​century
● The​ ​idea​ ​of​ ​using​ ​immunotherapy​ ​resurfaced​ ​around​ ​the​ ​late​ ​20th​ ​century
○ It​ ​is​ ​quickly​ ​becoming​ ​a​ ​promising​ ​new​ ​strategy,​ ​however,​ ​for​ ​decreasing​ ​the​ ​size
of/destroying​ ​tumors
○ It​ ​has​ ​seen​ ​its​ ​most​ ​success​ ​in​ ​today’s​ ​society​ ​with​ ​myriads​ ​of​ ​blood​ ​cancers,​ ​most
notably​ ​lymphomas​ ​and​ ​leukemias
■ Immunotherapies​ ​are​ ​frequently​ ​used​ ​in​ ​clinical​ ​trials​ ​featuring​ ​solid
tumors​ ​like​ ​prostate,​ ​breast,​ ​colon,​ ​and​ ​brain​ ​cancers

IMMUNOTHERAPY​ ​IN​ ​TODAY’S​ ​SOCIETY…

● Immunotherapy​ ​has​ ​recently​ ​become​ ​a​ ​vital​ ​part​ ​of​ ​cancer​ ​treatment
● This​ ​past​ ​year​ ​(2016-2017)​ ​the​ ​US​ ​Food​ ​and​ ​Drug​ ​Administration​ ​sanctioned​ ​new
immunotherapies​ ​for​ ​the​ ​treatment​ ​of​ ​melanoma,​ ​lung​ ​cancer,​ ​and​ ​kidney​ ​cancer
● Once​ ​again,​ ​immunotherapy​ ​harnesses​ ​the​ ​body’s​ ​natural​ ​strength​ ​to​ ​fight​ ​cancer​ ​and
“motivates”​ ​the​ ​immune​ ​system​ ​to​ ​combat​ ​more​ ​types​ ​of​ ​cancer​ ​cells
○ Some​ ​examples​ ​of​ ​some​ ​BRMs…
■ Antibodies​:​ ​specific​ ​proteins​ ​that​ ​attach​ ​themselves​ ​to​ ​antigens​ ​on
harmful​ ​invaders​ ​in​ ​the​ ​body​ ​(such​ ​as​ ​germs)
● Additionally,​ ​they​ ​“mark”​ ​cells​ ​for​ ​attack​ ​and​ ​destruction​ ​by​ ​other
immune​ ​cells
■ B​ ​cells:​ ​their​ ​job​ ​is​ ​to​ ​release​ ​several​ ​types​ ​of​ ​antibodies​ ​to​ ​defend​ ​against
harmful​ ​invaders​ ​in​ ​the​ ​body
● Furthermore,​ ​there​ ​are​ ​a​ ​plethora​ ​of​ ​types​ ​of​ ​b​ ​cells​ ​and​ ​each​ ​is
programmed​ ​to​ ​make​ ​one​ ​specific​ ​type​ ​of​ ​antibody
○ I.e​ ​one​ ​for​ ​the​ ​flu​ ​or​ ​common​ ​cold
■ CD8+​ ​Killer​ ​T​ ​Cells:​​ ​in​ ​simple​ ​terms,​ ​these​ ​types​ ​of​ ​t​ ​cells​ ​destroy
thousands​ ​upon​ ​thousand​ ​of​ ​cells​ ​that​ ​have​ ​been​ ​infected​ ​by​ ​some​ ​type​ ​of
virus
● Occasionally,​ ​this​ ​particular​ ​type​ ​of​ ​t​ ​cell​ ​will​ ​seek​ ​to​ ​destroy
(hence​ ​why​ ​the​ ​name​ ​is​ ​“killer​ ​t​ ​cells”)​ ​cancerous​ ​cells
■ Cytokines:​​ ​referred​ ​to​ ​as​ ​messenger​ ​molecules​ ​that​ ​assist​ ​immune​ ​cells​ ​in
communicating​ ​with​ ​each​ ​other​ ​to​ ​help​ ​facilitate​ ​immune​ ​responses
● I.e.​ ​cytokines​ ​ensure​ ​that​ ​the​ ​immune​ ​system​ ​only​ ​releases​ ​white
blood​ ​cells​ ​to​ ​a​ ​particular​ ​region​ ​/​ ​the​ ​infected​ ​region​ ​within​ ​the
body
■ CD4+​ ​Helper​ ​T​ ​Cells:​​ ​unlike​ ​the​ ​CD8+​ ​killer​ ​t​ ​cells,​ ​these​ ​t​ ​cells​ ​send
“help”​ ​signals​ ​to​ ​other​ ​immune​ ​cells​ ​so​ ​they​ ​can​ ​become​ ​more​ ​efficient
when​ ​destroying​ ​harmful​ ​bacteria/cells
● Moreover,​ ​they​ ​help​ ​to​ ​maintain​ ​lines​ ​of​ ​communication​ ​with​ ​B
cells
● Display​ ​a​ ​similar​ ​role​ ​to​ ​someone​ ​in​ ​an​ ​emergency...the​ ​person​ ​in
need​ ​of​ ​assistance​ ​sends​ ​a​ ​“help​ ​signal”​ ​to​ ​others​ ​so​ ​that​ ​they​ ​can
avoid​ ​the​ ​harmful​ ​situation​ ​at​ ​stake
■ Macrophages:​​ ​“macro”​ ​=​ ​big,​ ​hence​ ​macrophages​ ​are​ ​referred​ ​to​ ​as​ ​the
“big​ ​eaters”
● These​ ​big​ ​eaters​ ​of​ ​the​ ​immune​ ​system​ ​are​ ​known​ ​for​ ​their​ ​ability
to​ ​engulf,​ ​kill,​ ​and​ ​destroy​ ​other​ ​bacteria​ ​that​ ​is​ ​deemed​ ​harmful​ ​by
the​ ​body
 ● Another​ ​major​ ​role​ ​macrophages​ ​play​ ​is​ ​that​ ​they​ ​present​ ​antigens
(essentially​ ​bacteria​ ​from​ ​outside​ ​the​ ​body)​ ​to​ ​various​ ​cells​ ​of​ ​the
immune​ ​system
■ Dendritic​ ​cells:​​ ​most​ ​prominent​ ​for​ ​their​ ​prowess​ ​in​ ​digesting​ ​cancerous
or​ ​foreign​ ​cells​ ​and​ ​presenting​ ​these​ ​to​ ​the​ ​immune​ ​cells​ ​so​ ​they​ ​can
destroy​ ​them
● Most​ ​people​ ​refer​ ​to​ ​dendritic​ ​cells​ ​as​ ​the​ ​“tattle-tale”...they​ ​inform
the​ ​“teacher”​ ​(immune​ ​system)​ ​of​ ​the​ ​“accident”
(cancerous/foreign​ ​cells)​ ​and​ ​“the​ ​troublemaker​ ​is​ ​punished”​ ​(the
cancerous​ ​cells​ ​are​ ​destroyed)

IMMUNOTHERAPY...BRAIN​ ​CANCER..POSSIBLE​ ​CURE?

● Brain​ ​cancer​ ​is​ ​one​ ​of​ ​the​ ​primary​ ​cancers​ ​which​ ​drastically​ ​affects​ ​children​ ​and​ ​young
adults​ ​(it​ ​is​ ​most​ ​prominent​ ​within​ ​these​ ​age​ ​groups)
○ Surprisingly,​ ​according​ ​to​ ​the​ ​cancer​ ​research​ ​institute,​ ​1​ ​in​ ​161​ ​individuals​ ​born
today​ ​will​ ​eventually​ ​develop​ ​some​ ​form​ ​of​ ​brain/nervous​ ​system​ ​cancer​ ​within
their​ ​lifetime
● As​ ​the​ ​brain​ ​tumors​ ​continue​ ​to​ ​grow​ ​and​ ​expand,​ ​they​ ​exacerbate​ ​the​ ​symptoms​ ​of
cancer
○ For​ ​example,​ ​a​ ​fast-growing​ ​tumor​ ​can​ ​cause​ ​a​ ​wide​ ​array​ ​of​ ​painful,​ ​critical,​ ​and
life-altering​ ​symptoms​ ​for​ ​the​ ​patient​ ​(increased​ ​headaches,​ ​migraines,​ ​etc)
○ These​ ​kinds​ ​of​ ​tumors​ ​impose​ ​upon​ ​brain​ ​tissue​ ​and​ ​at​ ​their​ ​least​ ​powerful​ ​stage
can​ ​interfere​ ​with​ ​normal​ ​brain​ ​function
○ Although​ ​brain​ ​cancer​ ​can​ ​be​ ​highly​ ​invasive,​ ​the​ ​majority​ ​of​ ​brain​ ​cancers​ ​do​ ​not
spread​ ​beyond​ ​the​ ​region​ ​of​ ​the​ ​brain​ ​and​ ​central​ ​nervous​ ​system
● Many​ ​neurosurgeons​ ​and​ ​doctors​ ​consider​ ​brain​ ​cancer​ ​to​ ​be​ ​inexplicable​ ​and
confounding​ ​at​ ​several​ ​times​ ​since​ ​the​ ​harmful​ ​disease​ ​is​ ​not​ ​yet​ ​fully​ ​understood
○ For​ ​this​ ​exact​ ​reason,​ ​several​ ​clinical​ ​trials​ ​and​ ​immunotherapy​ ​treatments​ ​are
being​ ​developed​ ​and​ ​tested​ ​out
■ According​ ​to​ ​various​ ​sources,​ ​the​ ​two​ ​most​ ​commonly​ ​used​ ​and
fully-approved​ ​immunotherapies​ ​for​ ​brain​ ​cancer​ ​include…
● 1.​ ​Bevacizumab​ ​(for​ ​adults)
● 2.​ ​Dinutuximab​ ​(for​ ​children)
■ Some​ ​examples​ ​of​ ​immunotherapies​ ​currently​ ​being​ ​experimented​ ​and
applied​ ​in​ ​clinical​ ​trials​ ​include…
● Adoptive​ ​cell​ ​therapy
● Cancer​ ​vaccines
● Checkpoint​ ​inhibitors
● Monoclonal​ ​antibodies
● Despite​ ​the​ ​rapidly​ ​trending​ ​advances​ ​in​ ​brain​ ​cancer​ ​research,​ ​the​ ​mortality​ ​rain​ ​has
remained​ ​static​ ​for​ ​the​ ​past​ ​thirty​ ​years
○ As​ ​a​ ​result,​ ​many​ ​new​ ​immunotherapies​ ​are​ ​still​ ​being​ ​tested​ ​to​ ​treat​ ​such​ ​an
aggressive​ ​and​ ​pervasive​ ​disease
■ For​ ​example,​ ​in​ ​a​ ​report​ ​published​ ​in​ ​the​ ​New​ ​England​ ​Journal​ ​of
Medicine,​ ​researchers​ ​under​ ​their​ ​leader​ ​Dr.​ ​Behnam​ ​Badie​ ​from​ ​the​ ​City
of​ ​Hope​ ​Beckman​ ​Research​ ​Institute​ ​and​ ​Medical​ ​Center​ ​report​ ​that
immunotherapy​ ​successfully​ ​defeated​ ​blood​ ​cancers​ ​on​ ​a​ ​patient,​ ​and​ ​also
helped​ ​that​ ​same​ ​patient​ ​with​ ​advanced​ ​brain​ ​cancer
● This​ ​50​ ​year​ ​old​ ​man​ ​was​ ​diagnosed​ ​with​ ​glioblastoma,​ ​a​ ​VERY
aggressive​ ​type​ ​of​ ​brain​ ​tumor​ ​and​ ​had​ ​already​ ​been​ ​treated​ ​with
several​ ​other​ ​therapies​ ​including​ ​surgery​ ​and​ ​radiation.​ ​Despite​ ​the
innumerable​ ​attempts​ ​to​ ​completely,​ ​or​ ​at​ ​least​ ​temporarily,
eliminate​ ​the​ ​cancer,​ ​the​ ​disease​ ​had​ ​returned​ ​and​ ​had​ ​even​ ​spread
to​ ​various​ ​parts​ ​of​ ​the​ ​patient’s​ ​brain​ ​and​ ​spinal​ ​cord
● Next,​ ​Dr.​ ​Badie​ ​and​ ​his​ ​team​ ​of​ ​neurosurgeons​ ​extracted​ ​immune
cells​ ​from​ ​the​ ​50​ ​year​ ​old​ ​patient​ ​and​ ​genetically​ ​modified​ ​them​ ​so
that​ ​these​ ​immune​ ​cells​ ​would​ ​discern​ ​between​ ​glioblastoma​ ​tumor
cells​ ​and​ ​destroy​ ​those​ ​cells​ ​only.​ ​These​ ​genetically​ ​modified
immune​ ​cells​ ​known​ ​as​ ​antigen​ ​receptor​ ​T​ ​cells​ ​(a​ ​type​ ​of​ ​CD8+​ ​T
cell​ ​as​ ​aforementioned)​ ​prevented​ ​the​ ​tumor​ ​from​ ​further​ ​growth.
● Unfortunately,​ ​small​ ​growths​ ​in​ ​the​ ​brain​ ​still​ ​continued​ ​to​ ​grow,
but​ ​at​ ​a​ ​much​ ​more​ ​depressed​ ​rate​ ​when​ ​compared​ ​to​ ​before.​ ​The
patient​ ​received​ ​10​ ​more​ ​doses​ ​of​ ​the​ ​genetically​ ​modified​ ​T​ ​cells;
however,​ ​this​ ​time​ ​the​ ​injections​ ​were​ ​targeted​ ​in​ ​the​ ​cavities​ ​of
the​ ​brain,​ ​commonly​ ​known​ ​as​ ​the​ ​ventricles
○ This​ ​was​ ​the​ ​first​ ​time​ ​in​ ​immunotherapy​ ​history​ ​that​ ​cells
have​ ​been​ ​injected​ ​into​ ​the​ ​brain’s​ ​ventricles​ ​(introducing
something,​ ​any​ ​substance​ ​that​ ​is,​ ​into​ ​the​ ​ventricles
engenders​ ​precarious​ ​and​ ​deadly​ ​inflammation).
● Allaying​ ​the​ ​entire​ ​team’s​ ​fears,​ ​the​ ​genetically​ ​modified​ ​t​ ​cells​ ​did
not​ ​develop​ ​such​ ​critical​ ​complications;​ ​rather,​ ​the​ ​tumors​ ​actually
began​ ​to​ ​shrink​ ​substantially!​ ​The​ ​study​ ​reports​ ​that​ ​after​ ​about​ ​six
months,​ ​almost​ ​half​ ​of​ ​the​ ​tumors​ ​had​ ​disappeared
● If​ ​this​ ​patient​ ​had​ ​not​ ​received​ ​the​ ​CAR​ ​T​ ​therapy,​ ​according​ ​to
the​ ​study,​ ​he​ ​would’ve​ ​only​ ​survived​ ​a​ ​few​ ​additional​ ​weeks​ ​after
his​ ​cancer​ ​recurred
 ○ Since​ ​he​ ​was​ ​treated​ ​with​ ​the​ ​immunotherapy,​ ​however,​ ​his
cancer​ ​no​ ​longer​ ​recurred​ ​and​ ​the​ ​size​ ​of​ ​the​ ​brain​ ​tumors
were​ ​reduced​ ​significantly!
● After​ ​the​ ​success​ ​of​ ​this​ ​trial,​ ​Dr.​ ​Badie​ ​aspires​ ​to​ ​exploit​ ​this
information​ ​in​ ​the​ ​best​ ​way​ ​possible​ ​and​ ​introduce​ ​immune​ ​cells
with​ ​different​ ​proteins​ ​that​ ​are​ ​tailored​ ​to​ ​target​ ​specific​ ​tumors
○ For​ ​example,​ ​these​ ​proteins​ ​would​ ​be​ ​tailored​ ​specifically
to​ ​each​ ​patient’s​ ​cancer,​ ​thus​ ​making​ ​the​ ​treatment​ ​that
much​ ​more​ ​efficient​ ​and​ ​effective
● Overall,​ ​these​ ​points​ ​help​ ​to​ ​solidify​ ​and​ ​underpin​ ​the​ ​early
beginnings​ ​of​ ​the​ ​success​ ​of​ ​immunotherapy,​ ​especially​ ​in​ ​areas
where​ ​tumors​ ​are​ ​concrete​ ​and​ ​sprawling​ ​within​ ​the​ ​body!

IMMUNOTHERAPY...KIDNEY​ ​CANCER...POSSIBLE​ ​CURE?

● Kidney​ ​cancer​ ​is​ ​most​ ​frequent​ ​in​ ​women,​ ​especially​ ​those​ ​over​ ​the​ ​age​ ​of​ ​55
○ Within​ ​all​ ​these​ ​cases,​ ​63,000​ ​new​ ​cases​ ​of​ ​kidney​ ​cancer​ ​were​ ​diagnosed​ ​in​ ​2016
alone
○ The​ ​typical​ ​routine​ ​treatment​ ​for​ ​kidney​ ​cancers​ ​involves​ ​surgery
■ Commonly​ ​known​ ​as​ ​renal​ ​cell​ ​cancers
■ Unfortunately,​ ​various​ ​types​ ​of​ ​kidney​ ​cancers​ ​are​ ​immune​ ​to​ ​other
treatments​ ​such​ ​as​ ​chemotherapy​ ​and​ ​radiation,​ ​thus​ ​making​ ​treatment​ ​less
broad
● For​ ​this​ ​exact​ ​reason,​ ​immunotherapies​ ​are​ ​becoming​ ​more
essential​ ​to​ ​treating​ ​advanced​ ​kidney​ ​cancers
● Since​ ​immunotherapies​ ​are​ ​more​ ​crucial​ ​components​ ​of​ ​treating​ ​advanced​ ​renal​ ​cell
cancer,​ ​a​ ​myriad​ ​of​ ​immunotherapies​ ​have​ ​been​ ​approved​ ​by​ ​the​ ​FDA​ ​(US​ ​Food​ ​and
Drug​ ​Administration)
○ As​ ​a​ ​result,​ ​these​ ​approved​ ​immunotherapies​ ​are​ ​often​ ​the​ ​first​ ​treatment​ ​method
that​ ​medical​ ​staff​ ​turn​ ​to​ ​for​ ​advanced​ ​stages​ ​of​ ​kidney​ ​cancer
○ Some​ ​immunotherapy​ ​drugs​ ​approved​ ​by​ ​the​ ​FDA​ ​can​ ​only​ ​be​ ​implemented​ ​into
treatment​ ​at​ ​a​ ​specific​ ​time​ ​or​ ​in​ ​conjunction​ ​with​ ​other​ ​treatments
■ For​ ​example,​ ​the​ ​checkpoint​ ​inhibitor​ ​nivolumab​ ​was​ ​approved​ ​by​ ​the
FDA​ ​to​ ​treat​ ​kidney​ ​cancer​ ​that​ ​has​ ​metastasized​ ​(meaning​ ​that​ ​the​ ​cancer
has​ ​spread​ ​to​ ​other​ ​parts​ ​of​ ​the​ ​body)
● Chemotherapy​ ​can​ ​only​ ​be​ ​used​ ​on​ ​a​ ​patient​ ​after​ ​he​ ​or​ ​she​ ​has
been​ ​treated​ ​with​ ​this​ ​immunotherapy​ ​and​ ​only​ ​after​ ​all​ ​other
targeted​ ​therapies​ ​and​ ​immunotherapies​ ​have​ ​been​ ​attempted
● Checkpoint​ ​inhibitor:​ ​drugs,​ ​often​ ​made​ ​of​ ​antibodies,​ ​that​ ​release
an​ ​immune​ ​system​ ​attack​ ​on​ ​cancerous​ ​cells
 ○ Cytokine​ ​immunotherapies​ ​(​messenger​ ​molecules​ ​that​ ​assist​ ​immune​ ​cells​ ​in
communicating​ ​with​ ​each​ ​other​ ​to​ ​help​ ​facilitate​ ​immune​ ​responses)​ ​have​ ​been
constantly​ ​used​ ​to​ ​treat​ ​kidney​ ​cancer​ ​for​ ​the​ ​past​ ​decade
● Besides​ ​cytokines​ ​and​ ​targeted​ ​therapies,​ ​many​ ​other​ ​immunotherapy​ ​treatments​ ​are
becoming​ ​more​ ​eminent​ ​and​ ​distinguished​ ​in​ ​the​ ​field​ ​of​ ​kidney​ ​cancer
○ Some​ ​of​ ​these​ ​“on​ ​the​ ​rise”​ ​treatments​ ​for​ ​kidney​ ​cancer​ ​include,​ ​but​ ​are​ ​not
limited​ ​to​ ​checkpoint​ ​inhibitors,​ ​immune​ ​modulators,​ ​cancer​ ​vaccines,​ ​adoptive
cell​ ​therapy,​ ​monoclonal​ ​antibodies,​ ​cytokines,​ ​and​ ​adjuvant​ ​therapies
■ Even​ ​though​ ​many​ ​of​ ​these​ ​kidney​ ​cancer​ ​treatments​ ​are​ ​still​ ​undergoing
approval​ ​by​ ​the​ ​FDA,​ ​their​ ​application​ ​and​ ​effectiveness​ ​in​ ​the​ ​medical
field​ ​has​ ​made​ ​immunotherapy​ ​appear​ ​as​ ​a​ ​promising​ ​remedy​ ​for​ ​future
cases​ ​of​ ​cancer
● Kidney​ ​cancer​ ​is​ ​ranked​ ​#5​ ​on​ ​the​ ​most​ ​common​ ​types​ ​of​ ​cancer,​ ​according​ ​to​ ​the
National​ ​Cancer​ ​Institute
○ It​ ​is​ ​one​ ​of​ ​the​ ​major​ ​cancer​ ​types​ ​for​ ​which​ ​immunotherapy​ ​treatments​ ​are​ ​most
prevalent​ ​and​ ​being​ ​developed​ ​in​ ​clinical​ ​studies/experiments
○ Currently,​ ​the​ ​approved​ ​FDA​ ​immunotherapy​ ​drugs​ ​provide​ ​patients​ ​with​ ​less
than​ ​optimal​ ​results
■ Therefore,​ ​enrolling​ ​in​ ​a​ ​clinical​ ​trial​ ​or​ ​participating​ ​in​ ​a​ ​preclinical​ ​study
would​ ​benefit​ ​a​ ​patient​ ​the​ ​most​ ​and/or​ ​may​ ​be​ ​a​ ​safer​ ​choice​ ​for​ ​those
affected​ ​by​ ​kidney​ ​cancer
● Types​ ​of​ ​immunotherapies​ ​targeted​ ​for​ ​combatting​ ​kidney​ ​cancer
○ Interleukin-2​ ​(IL-2,​ ​Proleukin)​:​ ​type​ ​of​ ​immunotherapy​ ​that​ ​is​ ​targeted​ ​for
treating​ ​cancer​ ​in​ ​its​ ​latter​ ​stage
■ A​ ​cellular​ ​hormone​ ​called​ ​a​ ​cytokine​ ​that​ ​is​ ​produced​ ​by​ ​white​ ​blood​ ​cells
■ It​ ​is​ ​vital​ ​in​ ​the​ ​destruction​ ​of​ ​tumor​ ​cells
○ High-dose​ ​IL-2:
■ High​ ​dose:​ ​can​ ​cause​ ​drastic​ ​and​ ​harsh​ ​side​ ​effects​ ​including,​ ​but​ ​not
limited​ ​to,​ ​low​ ​blood​ ​pressure,​ ​excess​ ​fluid​ ​in​ ​lungs,​ ​heart​ ​attack,​ ​bleeding,
chills,​ ​and​ ​fever
● Patients​ ​who​ ​receive​ ​a​ ​high​ ​dose​ ​treatment​ ​may​ ​need​ ​to​ ​reside​ ​in​ ​a
hospital​ ​for​ ​an​ ​extended​ ​period​ ​(usually​ ​10​ ​days)
● Some​ ​symptoms​ ​are​ ​actually​ ​reversible​ ​and​ ​the​ ​side​ ​effects​ ​can​ ​be
rescinded​ ​in​ ​a​ ​sense
● Only​ ​hospitals​ ​and​ ​other​ ​clinical​ ​settings​ ​with​ ​expertise​ ​in​ ​high
dose​ ​treatment​ ​should​ ​recommend​ ​this​ ​immunotherapy​ ​drug​ ​for
patients
○ If​ ​the​ ​hospital​ ​is​ ​not​ ​equipped​ ​to​ ​treat​ ​a​ ​patient​ ​with​ ​the​ ​side
effects​ ​of​ ​high​ ​dose​ ​IL-2,​ ​the​ ​situation​ ​will​ ​only​ ​exacerbate
 ● High​ ​dose​ ​IL-2​ ​can​ ​even​ ​cure​ ​a​ ​small​ ​percentage​ ​of​ ​patients​ ​with
metastatic​ ​kidney​ ​cancer​ ​(meaning​ ​the​ ​cancer​ ​has​ ​spread​ ​to​ ​other
organs​ ​or​ ​body​ ​parts)
■ Low​ ​dose:​ ​causes​ ​fewer​ ​side​ ​effects​ ​that​ ​are​ ​less​ ​severe;​ ​however,​ ​it​ ​is​ ​not
as​ ​effective​ ​as​ ​high​ ​dose​ ​IL-2
● Hospitals​ ​that​ ​use​ ​this​ ​immunotherapy​ ​drug​ ​decide​ ​to​ ​choose​ ​low
dose​ ​IL-2​ ​because​ ​it​ ​has​ ​fewer​ ​side​ ​effects​ ​and​ ​the​ ​hospital​ ​itself​ ​is
more​ ​equipped​ ​to​ ​treat​ ​patients​ ​with​ ​low​ ​dose​ ​IL-2
○ Alpha-interferon​:​ ​another​ ​type​ ​of​ ​treatment​ ​for​ ​patients​ ​whose​ ​kidney​ ​cancer​ ​has
metastasized
■ Its​ ​role​ ​is​ ​to​ ​change​ ​the​ ​proteins​ ​on​ ​the​ ​surface​ ​of​ ​the​ ​cancer​ ​cells​ ​and​ ​slow
down​ ​the​ ​growth​ ​of​ ​the​ ​cancerous​ ​cells
■ It​ ​has​ ​been​ ​proven​ ​that​ ​it​ ​is​ ​NOT​ ​as​ ​beneficial​ ​as​ ​IL-2
● However,​ ​it​ ​is​ ​has​ ​been​ ​proven​ ​that​ ​interferon​ ​can​ ​lengthen​ ​the
lives​ ​of​ ​patients
○ Researchers​ ​have​ ​tested​ ​multiple​ ​combinations​ ​of​ ​alpha-interferon​ ​and​ ​IL-2​ ​for
patients​ ​who​ ​possess​ ​latter​ ​stages​ ​of​ ​kidney​ ​cancer
■ Furthermore,​ ​these​ ​combinations​ ​have​ ​also​ ​been​ ​tested​ ​in​ ​conjunction​ ​with
chemotherapy
● Unfortunately,​ ​a​ ​combination​ ​of​ ​these​ ​treatments​ ​does​ ​not​ ​provide
sufficient​ ​evidence​ ​that​ ​the​ ​patient​ ​will​ ​improve​ ​faster
● As​ ​a​ ​result,​ ​IL-2​ ​and​ ​interferon​ ​can​ ​produce​ ​just​ ​as​ ​positive​ ​a​ ​result
as​ ​a​ ​combination​ ​of​ ​several​ ​other​ ​treatments
○ Nivolumab​ ​(opdivo​ ​--​ ​checkpoint​ ​inhibitor):
■ Recently​ ​tested​ ​in​ ​kidney​ ​cancer
■ Administered​ ​intravenously​ ​every​ ​two​ ​weeks​ ​and​ ​was​ ​shown​ ​to​ ​ameliorate
the​ ​conditions​ ​and​ ​lengthen​ ​the​ ​lives​ ​of​ ​certain​ ​patients​ ​who​ ​had
previously​ ​received​ ​treatment

ADVANTAGES​ ​OF​ ​IMMUNOTHERAPY

● The​ ​2​ ​remarkable​ ​strengths​ ​of​ ​a​ ​human’s​ ​immune​ ​system​ ​are​ ​specificity​ ​and​ ​memory
○ Since​ ​the​ ​immune​ ​system​ ​is​ ​very​ ​specific,​ ​whenever​ ​white​ ​blood​ ​cells​ ​must
attack,​ ​the​ ​immune​ ​system​ ​“sends​ ​a​ ​message”​ ​to​ ​tell​ ​the​ ​white​ ​blood​ ​cells​ ​to​ ​aim
for​ ​a​ ​precise​ ​target
■ In​ ​immunotherapy,​ ​specificity​ ​is​ ​not​ ​merely​ ​an​ ​accommodation;​ ​it​ ​is​ ​vital
■ Immunotherapy​ ​will​ ​be​ ​highly​ ​advantageous​ ​if​ ​it​ ​is​ ​tailored​ ​to​ ​attacking​ ​a
specific​ ​area​ ​as​ ​opposed​ ​to​ ​a​ ​general​ ​area,​ ​where​ ​it​ ​could​ ​run​ ​the​ ​risk​ ​of
destroying​ ​or​ ​killing​ ​perfectly​ ​healthy​ ​cells
 ● For​ ​example,​ ​the​ ​common​ ​forms​ ​of​ ​cancer​ ​treatment​ ​such​ ​as
radiation​ ​and​ ​chemotherapy​ ​are​ ​highly​ ​successful;​ ​however,​ ​they
are​ ​systemic​ ​and​ ​affect​ ​normal​ ​cells​ ​in​ ​conjunction​ ​with​ ​cancerous
cells
● Fun​ ​fact:​ ​some​ ​chemotherapies​ ​are​ ​now​ ​being​ ​induced​ ​in​ ​a
particular​ ​region​ ​of​ ​the​ ​body,​ ​as​ ​opposed​ ​to​ ​a​ ​systemic​ ​injection
○ The​ ​immune​ ​system’s​ ​definition​ ​of​ ​memory​ ​is​ ​that​ ​it​ ​maintains​ ​the​ ​ability​ ​to
remember​ ​what​ ​it​ ​has​ ​been​ ​sensitized​ ​against​ ​and​ ​the​ ​ability​ ​to​ ​mobilize​ ​in​ ​the
future,​ ​should​ ​the​ ​immune​ ​system​ ​ever​ ​be​ ​exposed​ ​to​ ​the​ ​same​ ​target​ ​again
■ Memory​ ​is​ ​so​ ​salient​ ​in​ ​the​ ​immune​ ​system​ ​because​ ​without​ ​out,​ ​the
immune​ ​system​ ​would​ ​not​ ​be​ ​able​ ​to​ ​prevent​ ​future​ ​relapse​ ​or​ ​recurrences
of​ ​cancer
● Two​ ​additional​ ​advantages​ ​to​ ​immunotherapy​ ​that​ ​have​ ​allowed​ ​the​ ​treatment​ ​to
overcome​ ​obstacles​ ​that​ ​have​ ​limited​ ​the​ ​effectiveness​ ​of​ ​other​ ​cancer​ ​treatments
include…
○ 1.​ ​Delivery:​ ​the​ ​immune​ ​system​ ​has​ ​the​ ​ability​ ​to​ ​successfully​ ​navigate
throughout​ ​any​ ​part​ ​of​ ​the​ ​body​ ​since​ ​it​ ​is​ ​a​ ​body​ ​system​ ​in​ ​itself
■ For​ ​example,​ ​drug​ ​delivery​ ​is​ ​a​ ​major​ ​dilemma​ ​for​ ​brain​ ​cancer​ ​because
the​ ​blood​ ​supply​ ​to​ ​the​ ​brain​ ​has​ ​a​ ​protective​ ​barrier,​ ​otherwise​ ​known​ ​as
the​ ​blood​ ​brain​ ​barrier​ ​(BBB).​ ​If​ ​the​ ​penetration​ ​of​ ​the​ ​BBB​ ​is​ ​lacking,
then​ ​the​ ​drug​ ​will​ ​fail​ ​to​ ​improve​ ​any​ ​symptoms​ ​and​ ​will​ ​only​ ​exacerbate
the​ ​patient’s​ ​situation.​ ​The​ ​immune​ ​system,​ ​however,​ ​has​ ​the​ ​ability​ ​to
flawlessly​ ​bypass​ ​the​ ​BBB​ ​and​ ​allow​ ​for​ ​effective​ ​delivery​ ​of
immunotherapies​ ​to​ ​tumors​ ​in​ ​the​ ​brain.​ ​Hence,​ ​immunotherapies​ ​are​ ​now
being​ ​highly​ ​considered​ ​as​ ​the​ ​primary​ ​care​ ​option​ ​in​ ​several​ ​types​ ​of
brain​ ​cancers!
○ 2.​ ​Heterogeneity:​ ​in​ ​terms​ ​of​ ​the​ ​immune​ ​system,​ ​this​ ​can​ ​be​ ​defined​ ​as​ ​the
differences​ ​that​ ​define​ ​different​ ​cells​ ​in​ ​a​ ​tumor
■ I.e.​ ​most​ ​of​ ​these​ ​differences​ ​occur​ ​geographically,​ ​meaning​ ​that​ ​cells​ ​that
are​ ​a​ ​part​ ​of​ ​the​ ​tumor​ ​in​ ​different​ ​areas​ ​differ​ ​drastically,​ ​especially
including​ ​their​ ​sensitivity​ ​to​ ​treatment
● These​ ​differences​ ​can​ ​also​ ​occur​ ​gradually​ ​over​ ​time,​ ​causing​ ​the
tumor​ ​to​ ​acclimate​ ​itself​ ​better​ ​to​ ​the​ ​environment,​ ​or​ ​even​ ​worse,
become​ ​resistant​ ​to​ ​several​ ​types​ ​of​ ​treatment
■ For​ ​the​ ​most​ ​part​ ​in​ ​cancer​ ​history,​ ​this​ ​has​ ​been​ ​an​ ​unassailable​ ​obstacle
when​ ​attempting​ ​to​ ​develop​ ​successful​ ​brain​ ​cancer​ ​treatment
● Immunotherapy​ ​now​ ​has​ ​the​ ​potential​ ​to​ ​vanquish​ ​this​ ​hurdle​ ​as
long​ ​as​ ​it​ ​can​ ​be​ ​successfully​ ​sensitized​ ​against​ ​multiple​ ​variations
within​ ​the​ ​tumor
 ● A​ ​few​ ​more​ ​advantages​ ​of​ ​immunotherapy​ ​include…
○ 1.​ ​Fewer​ ​side​ ​effects​ ​in​ ​comparison​ ​to​ ​other​ ​treatments
■ The​ ​most​ ​common​ ​symptoms​ ​for​ ​immunotherapy​ ​include
● Fever,​ ​fatigue,​ ​rash,​ ​dizziness,​ ​or​ ​flu-like​ ​symptoms
● These​ ​symptoms​ ​often​ ​begin​ ​to​ ​ease​ ​up​ ​after​ ​the​ ​patient’s​ ​first
treatment
■ There​ ​are​ ​fewer​ ​side​ ​effects​ ​because​ ​immunotherapies​ ​work​ ​with​ ​the
immune​ ​system​ ​and​ ​target​ ​specific​ ​cells,​ ​as​ ​opposed​ ​to​ ​all​ ​the​ ​cells​ ​in​ ​the
body
○ 2.​ ​May​ ​work​ ​more​ ​effectively​ ​than​ ​other​ ​treatments​ ​or​ ​may​ ​even​ ​work​ ​more
effectively​ ​in​ ​conjunction​ ​with​ ​other​ ​treatments
■ In​ ​some​ ​cases​ ​like​ ​skin​ ​cancer,​ ​chemotherapy​ ​or​ ​radiation​ ​causes​ ​the​ ​body
to​ ​respond​ ​negatively​ ​and​ ​doesn’t​ ​have​ ​an​ ​entirely​ ​positive​ ​effect​ ​on​ ​the
cancer.​ ​When​ ​immunotherapies​ ​were​ ​used​ ​in​ ​cases​ ​of​ ​skin​ ​cancer,​ ​much
of​ ​the​ ​cancer​ ​began​ ​to​ ​go​ ​away
■ In​ ​other​ ​cases,​ ​immunotherapy​ ​works​ ​best​ ​in​ ​conjunction​ ​with​ ​another
type​ ​of​ ​cancer​ ​treatment,​ ​such​ ​as​ ​chemotherapy
○ 3.​ ​Cancer​ ​will​ ​be​ ​less​ ​likely​ ​to​ ​recur​ ​or​ ​relapse
■ When​ ​treated​ ​with​ ​immunotherapies,​ ​the​ ​immune​ ​system​ ​becomes
sensitized​ ​against​ ​multiple​ ​variations​ ​of​ ​tumors​ ​and​ ​so​ ​they​ ​learn​ ​to​ ​attack
cancer​ ​cells​ ​if​ ​they​ ​ever​ ​come​ ​back​ ​(immune​ ​memory--as​ ​mentioned
before)
● This​ ​will​ ​allow​ ​people​ ​to​ ​stay​ ​cancer-free​ ​for​ ​a​ ​longer​ ​period​ ​of
time,​ ​which​ ​is​ ​making​ ​this​ ​treatment​ ​much​ ​more​ ​universal​ ​and
accepted

CHALLENGES/DISADVANTAGES​ ​OF​ ​IMMUNOTHERAPY

● Although​ ​several​ ​studies​ ​present​ ​cases​ ​with​ ​successful​ ​uses​ ​of​ ​immunotherapies,
scientists​ ​and​ ​doctors​ ​are​ ​only​ ​just​ ​beginning​ ​to​ ​fathom​ ​and​ ​harness​ ​the​ ​power​ ​of​ ​the
body’s​ ​natural​ ​defense​ ​system​ ​against​ ​cancer
● Many​ ​questions​ ​such​ ​as​ ​these​ ​have​ ​yet​ ​to​ ​be​ ​fully​ ​answered​ ​or​ ​explained
○ Why​ ​do​ ​some​ ​patients​ ​respond​ ​and​ ​others​ ​do​ ​not?
○ Why​ ​do​ ​some​ ​types​ ​of​ ​cancer​ ​respond​ ​better​ ​to​ ​immunotherapy​ ​than​ ​others?
○ Why​ ​do​ ​only​ ​a​ ​minority​ ​of​ ​patients​ ​achieve​ ​a​ ​long-lasting​ ​benefit​ ​to
immunotherapy?
■ Currently,​ ​the​ ​two​ ​factors​ ​that​ ​could​ ​be​ ​answers​ ​to​ ​these​ ​questions​ ​are
optimization​ ​and​ ​resistance
● Even​ ​though​ ​immunotherapy​ ​can​ ​be​ ​predicted​ ​to​ ​have​ ​a​ ​bright​ ​future​ ​as​ ​a​ ​cancer
treatment​ ​(and​ ​possible​ ​cure​ ​in​ ​many​ ​cases),​ ​the​ ​idea​ ​is​ ​still​ ​flawed​ ​in​ ​various​ ​aspects
○ In​ ​general,​ ​just​ ​as​ ​you​ ​would​ ​with​ ​allergies,​ ​one’s​ ​body​ ​could​ ​hurt,​ ​itch,​ ​swell,
turn​ ​red,​ ​or​ ​even​ ​get​ ​sore​ ​when​ ​treated​ ​with​ ​immunotherapies
■ These​ ​side​ ​effects,​ ​along​ ​with​ ​many​ ​others,​ ​can​ ​accompany
immunotherapy​ ​treatment.​ ​Believe​ ​it​ ​or​ ​not,​ ​but​ ​if​ ​one’s​ ​body​ ​has​ ​an
extreme​ ​reaction​ ​to​ ​immunotherapy,​ ​the​ ​patient​ ​could​ ​become​ ​more​ ​prone
to​ ​another​ ​illness,​ ​infection,​ ​or​ ​disease
● I.e.​ ​increased​ ​nerve​ ​damage​ ​or​ ​severe​ ​blood​ ​clotting
○ Immunotherapies,​ ​despite​ ​their​ ​objective​ ​of​ ​targeting​ ​a​ ​specific​ ​area,​ ​may​ ​actually
damage​ ​or​ ​harm​ ​essential​ ​body​ ​parts/organs
■ I.e.​ ​immunotherapies​ ​might​ ​accidentally​ ​inflict​ ​harm​ ​upon​ ​a​ ​patient’s
heart,​ ​liver,​ ​lungs,​ ​etc
○ Immunotherapy​ ​is​ ​NOT​ ​an​ ​overnight​ ​process​ ​and​ ​will​ ​actually​ ​take​ ​longer​ ​than
most​ ​other​ ​cancer​ ​treatments
■ Cancerous​ ​cells​ ​will​ ​not​ ​disappear​ ​quickly​ ​and​ ​tumors​ ​will​ ​not​ ​diminish​ ​in
size​ ​rapidly
■ Immunotherapy​ ​is​ ​a​ ​process​ ​whereby​ ​the​ ​immune​ ​system​ ​is​ ​“trained”​ ​to
recognize​ ​or​ ​sensitize​ ​against​ ​cancerous​ ​cells
■ Fortunately,​ ​clinical​ ​studied​ ​on​ ​long-term​ ​overall​ ​survival​ ​have​ ​reported
that​ ​positive​ ​responses​ ​to​ ​cancer​ ​immunotherapy​ ​have​ ​been​ ​long-lasting
● In​ ​other​ ​words,​ ​responses​ ​are​ ​beneficial​ ​even​ ​after​ ​the​ ​treatment
has​ ​been​ ​completed
○ This​ ​is​ ​NOT​ ​for​ ​everyone…
■ Not​ ​everyone​ ​will​ ​react​ ​the​ ​same​ ​way/respond​ ​to​ ​the​ ​stimuli​ ​in​ ​the​ ​same
fashion
● According​ ​to​ ​WebMD,​ ​immunotherapy​ ​is​ ​successful​ ​for​ ​less​ ​than
50%​ ​of​ ​the​ ​people​ ​who​ ​try​ ​it
○ Additionally,​ ​many​ ​people​ ​only​ ​respond​ ​to​ ​the​ ​stimuli​ ​in
what​ ​is​ ​known​ ​as​ ​a​ ​“partial​ ​response”
■ I.e.​ ​if​ ​a​ ​patient​ ​is​ ​receiving​ ​immunotherapy
treatment​ ​to​ ​diminish​ ​the​ ​size​ ​of​ ​a​ ​tumor,​ ​the​ ​tumor
could​ ​stop​ ​increasing​ ​in​ ​size​ ​or​ ​get​ ​smaller,​ ​but​ ​it
simply​ ​won’t​ ​go​ ​away
■ For​ ​this​ ​reason,​ ​many​ ​doctors​ ​are​ ​still​ ​investigating,
experimenting,​ ​and​ ​conducting​ ​research​ ​on
immunotherapy​ ​to​ ​fully​ ​comprehend​ ​and​ ​decipher
the​ ​behavior​ ​of​ ​several​ ​immunotherapies
■ A​ ​patient’s​ ​body​ ​may​ ​develop​ ​a​ ​high​ ​tolerance​ ​for​ ​immunotherapy​ ​or
simply​ ​have​ ​no​ ​effect​ ​on​ ​the​ ​body​ ​at​ ​all
 ● For​ ​example,​ ​immunotherapy​ ​can​ ​possibly​ ​have​ ​no​ ​effect​ ​on
cancerous​ ​cells,​ ​ultimately​ ​resulting​ ​in​ ​the​ ​tumor​ ​to​ ​begin​ ​growing
again

FUTURE​ ​CONSIDERATIONS
● As​ ​of​ ​the​ ​current​ ​moment,​ ​only​ ​a​ ​handful​ ​of​ ​immunotherapy​ ​drugs​ ​have​ ​officially​ ​been
approved​ ​as​ ​a​ ​treatment​ ​for​ ​cancer
○ However,​ ​there​ ​are​ ​thousands​ ​upon​ ​thousands​ ​of​ ​research​ ​studies​ ​and​ ​clinical
trials​ ​that​ ​implement​ ​the​ ​use​ ​of​ ​volunteers​ ​to​ ​experiment​ ​with​ ​new​ ​medicines​ ​that
are​ ​not​ ​approved/released​ ​to​ ​the​ ​public​ ​yet
● If​ ​one​ ​would​ ​aspire​ ​to​ ​seek​ ​out​ ​and​ ​experiment​ ​with​ ​immunotherapy​ ​treatment,​ ​that
person​ ​should​ ​ask​ ​his​ ​or​ ​her​ ​doctor​ ​of​ ​a​ ​trial​ ​that​ ​he​ ​or​ ​she​ ​could​ ​join
○ Consulting​ ​a​ ​physician​ ​is​ ​the​ ​best​ ​route​ ​to​ ​take​ ​as​ ​a​ ​physician​ ​can​ ​direct​ ​you​ ​to​ ​a
trial​ ​or​ ​possibly​ ​recommend​ ​an​ ​already​ ​approved​ ​immunotherapy​ ​drug
■ Moreover,​ ​a​ ​physician​ ​will​ ​be​ ​cognizant​ ​of​ ​the​ ​patient’s​ ​situation​ ​and
symptoms​ ​and​ ​base​ ​the​ ​treatment​ ​off​ ​of​ ​these​ ​conditions
● Even​ ​though​ ​stirring​ ​progress​ ​has​ ​been​ ​made​ ​throughout​ ​the​ ​past​ ​few​ ​years,​ ​physicians
and​ ​other​ ​medical​ ​researchers​ ​are​ ​only​ ​on​ ​the​ ​brim​ ​of​ ​fully​ ​comprehending
immunotherapy
○ Researching​ ​the​ ​immune​ ​system​ ​and​ ​harnessing​ ​its​ ​power​ ​to​ ​fight​ ​against​ ​other
diseases​ ​is​ ​a​ ​relatively​ ​new​ ​concept
○ To​ ​fully​ ​apprehend​ ​and​ ​truly​ ​grasp​ ​this​ ​innovative​ ​treatment,​ ​clinical​ ​and
laboratory​ ​research​ ​are​ ​required​ ​and​ ​vital​ ​to​ ​the​ ​growth​ ​and​ ​expansion​ ​of
immunotherapy​ ​as​ ​a​ ​worldwide​ ​treatment​ ​for​ ​cancer
○ Scientists​ ​seek​ ​to​ ​even​ ​grasp​ ​the​ ​full​ ​effects​ ​of​ ​already​ ​approved​ ​immunotherapies
since​ ​only​ ​a​ ​small​ ​minority​ ​of​ ​patients​ ​who​ ​receive​ ​this​ ​approved​ ​immunotherapy
achieve​ ​a​ ​durable​ ​benefit
 Works​ ​Cited

“Cancer​ ​Vaccines.”​ ​American​ ​Cancer​ ​Society​,

www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/cancer-v
accines.html.

Collender,​ ​Stan.​ ​“A​ ​Clinical​ ​Trial​ ​Saved​ ​My​ ​Life.​ ​It​ ​Could​ ​Save​ ​Yours,​ ​Too.”​ ​USA​ ​Today​ ​,​ ​6
Aug.​ ​2017,​ ​apple.news/AMVBgCqvdRQ2amt4jfYePhw.

“Immunotherapy​ ​for​ ​Kidney​ ​Cancer:​ ​The​ ​Past,​ ​Present,​ ​and​ ​Future.”​ ​Institute​ ​for​ ​Clinical
Immuno-Oncology​,​ ​23​ ​Mar.​ ​2017,​ ​accc-iclio.org/resources/kidney-cancer/.

Jäger,​ ​Elke.​ ​“Kidney​ ​Cancer.”​ ​CRI​,

www.cancerresearch.org/we-are-cri/home/cancer-types/kidney-cancer.

“Kidney​ ​Cancer:​ ​Treatment​ ​Options.”​ ​Cancer.Net​,​ ​15​ ​Nov.​ ​2016,

www.cancer.net/cancer-types/kidney-cancer/treatment-options.

Park,​ ​Alice.​ ​“Experimental​ ​Brain​ ​Cancer​ ​Treatment​ ​Is​ ​a​ ​Success.”​ ​Time​ ​-​ ​Health​,​ ​Time,​ ​28​ ​Dec.
2016,​ ​time.com/4618566/brain-cancer-treatment-immunotherapy/.

Reardon​ ​,​ ​David,​ ​and​ ​Michael​ ​Weller​ ​.​ ​“An​ ​Overview​ ​of​ ​Immunotherapy​ ​for​ ​Brain​ ​Cancer.”
IBTA​,​ ​2016,​ ​theibta.org/brain-tumour-magazine-201617/immunotherapy-overview-brain-cancer/.

“Risks​ ​and​ ​Benefits​ ​of​ ​Immunotherapy.”​ ​WebMD​,​ ​WebMD,

www.webmd.com/cancer/immunotherapy-risks-benefits#2.

Robertson,​ ​BSc​ ​Sally.​ ​“What​ ​Is​ ​Immunotherapy?”​ ​Medical​ ​News​,​ ​21​ ​Sept.​ ​2015,
www.news-medical.net/health/What-is-Immunotherapy.aspx.