Alison Halliday holds a PhD in molecular genetics from the University of Newcastle. As an award-winning freelance science communications specialist, she has 20+ years of experience across academia and industry.
For decades, surgery, chemotherapy and radiotherapy have been the mainstay of cancer treatment. While there have been dramatic improvements in survival for some cancers, there has been limited progress against others.
Fortunately, recent advances in the understanding of how the immune system works and how cancers can evade destruction by immune cells have given rise to a new type of treatment called immunotherapy
Download this listicle to learn more about:
Immune checkpoint inhibitors and immune system modulators
Adoptive cell therapies
Oncolytic viral therapy
Transforming Treatment for Patients
Alison Halliday, PhD
Cancer is a devastating disease that claims millions of lives each year, with around 19.3 million new
cases and nearly 10 million cancer deaths recorded in 2020 alone.1
The urgent need for effective
treatments is clear, especially as the incidence of the disease is projected to rise to 28.4 million cases by
For decades, surgery, chemotherapy and radiotherapy have been the mainstay of cancer treatment. While
there have been dramatic improvements in survival for some cancers, there has been limited progress
against others. As a result, there is a pressing need for innovative treatment modalities that can help
improve outcomes for patients.
Fortunately, recent advances in the understanding of how the immune system works and how cancers
can evade destruction by immune cells have given rise to a new type of treatment called immunotherapy.
The immune system plays a crucial role in protecting the body from diseases, including infections
and cancer. However, cancer cells can evade immune detection or suppress the immune response.
Immunotherapy aims to boost the immune system’s ability to find and destroy cancer cells by using
substances that help boost the overall immune response or activate specific immune cells.
In this listicle, we explore the different types of immunotherapies and how these approaches are
revolutionizing cancer treatment, delivering remarkable outcomes for some patients. We also discuss the
ongoing challenges that need to be overcome to fully unlock the transformative potential of these cancer
treatments – offering the hope of improved survival and quality of life for more people with cancer.
Immune checkpoint inhibitors
The immune system has a system of “brakes” called immune checkpoints to prevent it from mounting
an excessive response that could harm healthy cells and tissues. But cancer cells can sometimes
manipulate these checkpoints, allowing them to evade destruction. Immune checkpoint inhibitors are
drugs that work by blocking these immune checkpoints, effectively switching off the “brakes” on the
immune system and enabling it to find and attack cancer cells.
Over the past decade, immune checkpoint inhibitors have demonstrated a breakthrough in cancer
treatment – with several now approved to treat a variety of different cancers.2
For example, one drug
targets cytotoxic T lymphocyte-associated protein 4 (CTLA-4), a checkpoint protein found on the surface
of T cells – a type of immune cell that plays a crucial role in the immune response to cancer.
CANCER IMMUNOTHERAPIES: TRANSFORMING TREATMENT FOR PATIENTS 2
Other inhibitors target programmed cell death protein 1 (PD-1), another checkpoint protein found on T
cells, or its partner programmed cell death ligand 1 (PD-L1), which is sometimes found at high levels on
cancer cells to help them evade the immune response.
Adoptive cell therapies
In recent years, adoptive cell therapies have emerged as an exciting development in cancer treatment.3
The approach involves collecting the patient’s own immune cells, which are then either multiplied in the
laboratory or modified to enhance their ability to target and kill the cancer cells, before putting them back
into the body.
There are several types of adoptive cell therapy, including:
• Tumor-infiltrating lymphocyte (TIL) therapy: T cells extracted from the patient’s tumor are grown
in large numbers in the lab and re-administered back to the patient. While TIL therapy has shown
promising results for certain cancers like melanoma and breast cancer, it remains an experimental
• Chimeric antigen receptor T-cell (CAR T-cell) therapy: T cells are modified in the lab with CARs that
can recognize specific proteins – or antigens – on the surface of cancer cells. The US Food and Drug
Administration (FDA) has approved several CAR T-cell therapies for treating some types of blood
and researchers are exploring strategies to improve their effectiveness against solid tumors.5
• Engineered T-cell receptor (TCR) therapy: The patient’s T cells are engineered in the lab with
receptors that can detect cancer-associated antigens displayed on the surface of tumor cells. In 2022,
the first TCR therapy received FDA approval for a rare type of melanoma occurring in the eye.6
Researchers are also exploring adoptive cell therapies using immune cells from healthy donors to
develop “off-the-shelf” treatments for cancer patients.7
Antibodies are proteins that are produced by immune cells to help combat infections. Monoclonal
antibodies, also known as therapeutic antibodies, are created in the laboratory but mimic the function
of natural antibodies. Like the body’s own antibodies, they are designed to identify and stick to a specific
protein on the surface of cells.
Several monoclonal antibodies have been approved to treat a wide variety of cancers, and these
therapeutics are now considered to be a main component of cancer treatment.8
Some function as
immunotherapies by activating the immune system to fight cancer. For example, they may attach
themselves to cancer cells, facilitating recognition and destruction by immune cells – while others act
on immune cells to help the immune system attack cancer cells. Other antibodies may work in a more
targeted way, for example by blocking signals that stimulate cancer cells to divide.
Oncolytic viral therapy
Oncolytic viruses can infect and selectively kill cancer cells without harming healthy cells.9
can occur naturally or can be made in the laboratory by modifying existing viruses.
CANCER IMMUNOTHERAPIES: TRANSFORMING TREATMENT FOR PATIENTS 3
Researchers are investigating the potential of using oncolytic viruses to treat cancer, either alone or in
combination with other treatments such as chemotherapy or radiotherapy.
For many years, oncolytic viruses were considered tools for directly killing cancer cells. However,
emerging evidence suggests that some of these viruses may also work as immunotherapies, stimulating
the patient’s immune system to find and destroy other cancer cells.
In 2016, Talimogene laherparepvec (T-VEC) was the first oncolytic viral therapy to receive FDA approval to
treat advanced melanoma skin cancer.10 T-VEC is derived from the herpes simplex virus type 1, commonly
associated with cold sores.
Cancer treatment vaccines are designed to help the immune system recognize and react to tumorassociated antigens.11 Researchers are investigating several different types of therapeutic vaccines,
including those made from whole cancer cells, proteins or protein fragments, pieces of DNA or RNA or
In 2011, Sipuleucel-T was the first therapeutic cancer vaccine to be approved by the FDA as a treatment
for some men with advanced prostate cancer.12
Immune system modulators
Immune system modulators can boost the body’s immune response against cancer. They work by
targeting specific components of the immune system or have a broader effect. Examples include:
• Interleukins: These are a type of cytokine, a protein made by some immune cells to regulate the
immune response. A man-made version of interleukin-2 (IL-2) is approved to treat advanced kidney
cancer and melanoma.13
• Interferons: These are also cytokines that help make immune cells more active against cancer. IFN-a
is approved to treat cancers including leukemia, sarcoma, lymphoma and melanoma.14
• Immunomodulators: These treatments help stimulate the immune system to react to cancer. They
include thalidomide, lenalidomide, pomalidomide – which induces IL-2 release and inhibits tumor
blood vessel formation – and imiquimod, a topical cream that triggers cells to release cytokines. And
for many decades, Bacillus Calmette-Guérin (BCG), a live weakened strain of Mycobacterium bovis
used to prevent tuberculosis, has also been used as an immunotherapy for bladder cancer.14
Cancer immunotherapy represents a new paradigm in cancer care. The approach is already transforming
the lives of some patients – and holds immense promise for the future of cancer treatment.
However, several challenges will need to be overcome to bring the benefits of immunotherapy to all
cancer patients. Many tumors don’t respond well enough to immunotherapy, or the cancer develops
resistance and begins to grow and spread. These treatments can also cause side effects, many of which
occur because the activated immune system also attacks healthy tissues. Additionally, the high cost of
certain immunotherapies can limit their accessibility to patients.
CANCER IMMUNOTHERAPIES: TRANSFORMING TREATMENT FOR PATIENTS 4
Nevertheless, combining immunotherapeutic agents with other treatments like chemotherapy,
radiotherapy or targeted therapies has shown promising results in clinical trials. As these treatments all
work in different ways, such combination strategies offer the potential to eliminate cancer permanently.
Identifying biomarkers that can accurately predict which patients will respond to immunotherapy is also
a major area of research. Personalizing treatment based on a patient’s unique genetic and immunological
profile also offers the promise of more targeted and effective immunotherapies.
Gaining a better understanding of how cancer cells evade the immune system could lead to the
development of next-generation immunotherapies. These advancements provide hope for better
outcomes, improved survival and potentially even the eradication of certain types of cancer, bringing us
closer to a world where cancer is no longer a life-threatening disease.
1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660
2. Shiravand Y, Khodadadi F, Kashani SMA, et al. Immune checkpoint inhibitors in cancer therapy. Curr Oncol.
2022;29(5):3044-3060. doi: 10.3390/curroncol29050247
3. Rohaan MW, Wilgenhof S, Haanen JBAG. Adoptive cellular therapies: the current landscape. Virchows Arch.
2019;474(4):449-461. doi: 10.1007/s00428-018-2484-0
4. Sengsayadeth S, Savani BN, Oluwole O, Dholaria B. Overview of approved CAR-T therapies, ongoing clinical trials, and its
impact on clinical practice. eJHaem. 2021;3(S1):6-10. doi: 10.1002/jha2.338
5. Daei Sorkhabi A, Mohamed Khosroshahi L, Sarkesh A, et al. The current landscape of CAR T-cell therapy for solid tumors: Mechanisms, research progress, challenges, and counterstrategies. Front Immunol. 2023;14:1113882. doi: 10.3389/
6. Mullard A. FDA approval of Immunocore’s first-in-class TCR therapeutic broadens depth of the T cell engager platform.
Nat Rev Drug Discov. 2022;21(3):170. doi: 10.1038/d41573-022-00031-3
7. Perez C, Gruber I, Arber C. Off-the-Shelf allogeneic T cell therapies for cancer: Opportunities and challenges using naturally occurring “universal” donor T cells. Front Immunol. 2020;11:583716. doi: 10.3389/fimmu.2020.583716
8. Zahavi D, Weiner L. Monoclonal antibodies in cancer therapy. Antibodies. 2020;9(3):34. doi: 10.3390/antib9030034
9. Apolonio JS, Gonçalves VL de S, Santos MLC, et al. Oncolytic virus therapy in cancer: A current review. World J Virol.
2021;10(5):229-255. doi: 10.5501/wjv.v10.i5.229
10. Poh A. First oncolytic viral therapy for melanoma. Cancer Discov. 2016;6(1):6. doi: 10.1158/2159-8290.CD-NB2015-158
11. Saxena M, van der Burg SH, Melief CJM, Bhardwaj N. Therapeutic cancer vaccines. Nat Rev Cancer. 2021;21(6):360-378.
12. Cheever MA, Higano CS. PROVENGE (Sipuleucel-T) in prostate cancer: the first FDA-approved therapeutic cancer vaccine.
Clin Cancer Res. 2011;17(11):3520-3526. doi: 10.1158/1078-0432.CCR-10-3126
13. Antony GK, Dudek AZ. Interleukin 2 in cancer therapy. Curr Med Chem. 2010;17(29):3297-3302. doi:
14. Jiang S, Redelman-Sidi G. BCG in bladder cancer immunotherapy. Cancers. 2022;14(13):3073. doi: 10.3390/cancers14133073
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