Immunotherapy

Immunotherapy is a method of treatment which uses substances to encourage or to subdue your immune system to help your body fight cancer, infection, and other diseases.

Treating cancer with immunotherapy

Some types of immunotherapy target certain immune cells; others affect the whole immune system in a general way. The immune system has a tougher time targeting tumour cells than other foreign substances. This is because:

• Sometimes the tumour cells aren't different enough from normal cells for your immune system to see them as foreign
  (Unlike infectious organisms, tumours are fundamentally “self" i.e. are your body's own cells)
• Sometimes the immune system recognises the tumour cells, but its attack isn't strong enough to destroy the tumour
• Tumour cells can also give off signals that fool the immune system into thinking they are not foreign, or signals that shut down the local immune system activity

However, immunotherapy research has had some success in some tumours/cancers, by increasing survival by several months.

• In the US, the FDA (Food & Drug Administration) has approved some immunotherapy treatments, including immunotherapies for some skin, liver, breast, prostate, kidney and lung cancers.
• In Europe, the EMA's (European Medicines Agency) has approved immunotherapies that include those for some lung, bladder, skin, lymphoma and neuroblastoma cancers.

Treating brain tumours with immunotherapy

Unfortunately, there has, so far, been less success in brain tumours.

When it comes to the brain, immune-based treatments face a number of obstacles before they can even reach the tumour. One of the most significant challenges is the blood-brain barrier which protects the brain from harmful substances.

Also some brain tumours are very good masters of disguise and can use a 'cloak' of molecules to make them look like normal cells to the immune system. This prevents immune cells from attacking them.

For this reason, research is continuing within clinical trials, including looking at combining immunotherapy with other treatments, such as chemotherapy and radiotherapy, to improve results.

Clinical trials for immunotherapy treatment of brain tumours

As yet, immunotherapy isn't a proven treatment for brain tumours, but there are clinical trials that are helping us move closer to a treatment. For example:

• New phase 2 clinical trial testing immunotherapy drug
• Early findings from DCVax®-L phase 3 clinical trial report promising results

The Brain Tumour Charity is also funding immunotherapy research.

• Resetting the tumour microenvironment to improve glioblastoma immunotherapy
• Cancer-killing viruses in the fight against high grade gliomas
• Developing a personalised vaccine to beat brain tumours
  

Where to get more information

If you are interested in taking part in a clinical trial and would like to know more about whether immunotherapy is suitable for you, talk to your medical team. Below are some questions to help you with this.

You might find it helpful to think about any questions you have and write them down before going to see your doctor. It can also be helpful to have someone with you to write down the answers.

Questions to ask your doctor:

• What can you tell me about immunotherapy?
  
• Can I have immunotherapy? If not, what is suitable for me?
• How might I feel during immunotherapy treatment?
• What are the possible side-effects of immunotherapy?
• Are there any immunotherapy clinical trials for my brain tumour type?
• How can I request to be part of a clinical trial?
• Is it possible to access immunotherapy privately, if so where?
• How much does immunotherapy cost (privately)?

Types of immunotherapy

Current immunotherapies for brain tumours fall into six main categories (some of which overlap). These are known as: