Some types of immunotherapy have been approved to treat leukemia, a cancer of the white blood cells. Cancer immunotherapies are medications that help a person’s natural immune system recognize and fight cancer.
There are four main types of leukemia:
Immunotherapies that are effective at treating one type of leukemia may not effectively treat other types.
Using a person’s own immune system to fight cancer has several benefits:
Immunotherapy drugs harness these qualities to provide treatment that is more targeted to cancer cells and that usually causes milder side effects compared to other treatments.
There are multiple types of immunotherapies. Though each type works by a different mechanism, they all help the immune system target and kill leukemic cells.
Targeted antibodies are designed to affect one or more specific immune pathways. Antibodies are made naturally by the immune system to bind to specific targets, including bacteria, viruses, and cancer cells. Scientists have learned how to synthesize some of the antibodies that are most effective at fighting cancer.
Targeted antibodies include:
Campath (alemtuzumab) is a monoclonal antibody approved to fight CLL.
Blincyto (blinatumomab) is a bispecific antibody with two targets: a tumor-cell target and a T-cell target. T cells work to signal other immune cells, regulate the immune response, and kill cancer cells directly. Blinatumomab works by bringing T cells close to cancerous cells and activating them to kill. The U.S. Food and Drug Administration (FDA) has approved it for refractory (treatment-resistant) ALL.
Mylotarg (gemtuzumab ozogamicin) and Besponsa (inotuzumab ozogamicin) are antibody-drug conjugates. The combination delivers toxic drugs specifically to cancer cells. These targeted antibodies have been approved for some adults and children living with ALL.
Gazyva (obinutuzumab), Rituxan (rituximab), and Arzerra (ofatumumab) are monoclonal antibodies that have been FDA-approved to fight CLL. In some cases, they are a part of initial treatment.
Adoptive cell therapies entail taking out a person’s T cells, growing them in a laboratory, and then giving the T cells back to the person. Chimeric antigen receptor (CAR) T-cell therapy is a type of adoptive cell therapy, in which the T cells are taught how to better attack and kill cancer cells in the laboratory and then given back to the person with leukemia.
Kymriah (tisagenlecleucel) is a CAR T-cell therapy approved to treat some children and young adults with ALL.
See what Dr. Matt Kalaycio says about uses for CAR-T therapies.
Immunomodulators work to stimulate or suppress the immune system. Examples of immunomodulators include vaccines, cytokines, and the medication levamisole. So far, only two cytokines have been approved for the treatment of leukemia: interferon alfa-2a and interferon alfa-2b.
Interferon alfa-2a is a cytokine approved for some people living with Philadelphia chromosome-positive CML and hairy cell leukemia.
Interferon alfa-2b is a cytokine approved for some people living with hairy cell leukemia.
Like many cancer treatments, immunotherapy may work well for some people and not for others. Side effects of immunotherapy are often different from those of typical cancer treatments. They are usually caused by stimulation of the immune system. Side effects are typically minor and can include:
However, major life-threatening side effects have also been reported. Oncologists and researchers are working to better understand the risk factors for severe immunotherapy side effects.
There are ongoing clinical trials to test new targeted antibodies, cancer vaccines, immunomodulators, adoptive cell therapies, and oncolytic virus therapies. Many immunotherapies that haven’t been approved specifically to fight leukemia are available through these trials.
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