This document provides an overview of cancer immunotherapy. It discusses how immunotherapy harnesses the immune system to fight cancer through techniques like monoclonal antibodies, cytokines, adoptive cell therapy, and cancer vaccines. Monoclonal antibodies target specific antigens on cancer cells, while cytokines are proteins that serve as messenger molecules between immune cells. Adoptive cell therapy transfers immune cells back into patients to improve immune function against tumors. Cancer vaccines stimulate the immune system to attack existing or prevent future cancer cells. The document also outlines some limitations of immunotherapy approaches and notes how cancer immunotherapy was named Breakthrough of the Year by the journal Science in 2013.

1. Cancer
Immunotherapy
Submitted By -
Nivedita Shah
M.Sc. Biotechnology Part I
sem II
Banasthali Vidyapith
Roll no.- 13937

2. Introduction
Immunotherapy -the most recent advanced
technique in cancer therapy.
• Immunotherapy works to harness the innate
powers of the immune system to fight cancer.
• It fights cancer more powerfully, to offer long-
term protection, with less side effects.
• It may hold greater potential than current
treatments, due to unique properties of
Immune System.

3.  Immunotherapy is
often characterized as-
Active, Passive, or
Combinatory.
 Cancer
Immunotherapy is the
use of immune system to
reject Cancer. The main
purpose premise is
stimulating the patient’s
immune system to attack
the malignant tumour
cells that are responsible
for the disease.

4. FIG 1:
IMMUNOTHERA
PY

5. History
 Although cancer immunotherapy is being touted as a recent
breakthrough in cancer treatment, its origins at Memorial
Sloan Kettering go back more than a century. In the 1890s,
William Coley, a surgeon at New York Cancer Hospital (the
predecessor to Memorial Sloan Kettering) discovered cancer
patients who suffered from infections after surgery often fared
better than those who did not. His finding led to the
development of Coley’s toxins, a cocktail of inactive bacteria
injected into tumors that occasionally resulted in complete
remission. But eventually the use of this treatment fell out of
favor.
 In the 1960s, research by Memorial Sloan Kettering investigator
Lloyd Old led to the discovery of antibody receptors on the
surface of cancer cells, which enabled the development of the
first cancer vaccines and led to the understanding of how
certain white blood cells, known as T cells or T lymphocytes,
can be trained to recognize cancer.

7. Types of Cancer
Immunotherapy
Monoclonal Antibodies
Cytokines
Adoptive cell Therapy
Cancer Vaccines

8. Monoclonal Antibodies
 Monoclonal antibody(mAbs) therapy, is most widely
used, and a form of Passive Immunotherapy.

9. •It is a targeted therapy, directed to a single
target on a cancer cell, usually an antigen or
a receptor site on the cancer cell.
•It binds to Cancer cell-surface specific
antigens . When it recognize the antigen
against which it is directed, they fit together
like two pieces of a puzzle, setting of a
cascade of events leading to tumour cell
death.
Examples: Avastin, Erbitux, Rituxan,
Herceptin, Campath, Zevalin, Bexxar etc.

11. Types of Monoclonal
AntibodiesNaked mAbs
Naked mAbs work alone, and
are referred to as "naked"
because they are unmodified.
 Mark targets for immune
system - bind to targets and
make them more visible. The
immune system is triggered
and then destroys the target.
 Attach to antigens that are
responsible for sending
important signals that
contribute to the target's
reproduction.
 Binding to cell receptors, so
that proteins that trigger
growth are blocked. Usually
used in cancer treatments.
Conjugated mAbs
Conjugated mAbs are modified
with additional material.
 Radio immunotherapy (RIT) -
These mAbs have radioactive
particles directly attached, and
deliver them directly to
cancerous cells to kill them.
 Chemolabeled - These mAbs
have a chemotherapy drug
attached to their structures,
which would normally be too
powerful if delivered by itself.
This drug kills the cancerous
cell.

12. Cytokines[Active Immunotherapy]
•Cytokines are a large group of proteins, that
function as short range mediators involved in
essentially all biological processes.
•Cytokines serve as molecular messengers between
cells.
•They have important rate-limiting signals.
•These are chemically made by some immune
system cells.
•They are injected, either under the skin, into a
muscle, or into a vein.

13. Most common Cytokines
areInterleukins
 They act as chemical signals
between white blood cells.
 Interlukin-2(IL-2) help immune
system cells grow and divide
more quickly.
 A man-made version of IL-2 is
approved to treat advanced
kidney cancer and metastatic
melanoma.
 IL-2 can be used as a single
treatment for cancer, or can be
combined with chemotherapy
or with other cytokines such as
Interferon-α
Interferons
 These interferon (IFN) are
chemicals, helping body to resist
virus infection and cancer.
 Types of (IFN) are:
1. IFN-α, 2. IFN-β, 3. IFN-γ
 Only INF- α is used to treat
cancer.
 It is used to treat these cancers:
Hairy cell leukemia, Chronic
myeloid leukemia, Follicula non-
hodgkin’s lymphoma, cutaneous
t-cell lymphoma, kidney cancer,
melanoma, kaposi Sarcoma.

14. How does IFN-α
therapy works??

15. Adoptive Cell Therapy
•Adoptive cell transfer (ACT) is the transfer of cells into a
patient; as a form of cancer immunotherapy.
•It requires the generation of highly avoiding tumour-antigen-
reactive-T cells.
•The cells are most commonly derived from the immune
system, with the goal of transferring improved immune
functionality and characteristics along with the cells back to
the patient.
•Interleukin-2 is normally added to the extracted T cells to
boost their effectiveness, but in high doses it can have a toxic
effect.
•The reduced number of injected T cells is accompanied by
reduced IL-2, thereby reducing side effects.

16. ADOPTIVE CELL THERAPY

17. Cancer Vaccines
 Unlike other
vaccines, which
defends the
immune
system from
germs, Cancer
vaccines make
person’s
immune
system attack
cancer cells.

18. There are two Broad Types of Cancer Vaccines
1. Preventive Vaccines:
which are intended to prevent
cancer from developing in healthy people.
2. Treatment Vaccines:
which are intended to treat an
existing cancer by strengthening the body’s natural
defines against the cancer.
Cancer preventive vaccines target infectious agent that
cause or contribute to the development of cancer.

19. Limitations of
Immunotherapy1. Many mAbs are not administered as first-line therapy:
mAbs are usually administered as a second, third, or last resort
cancer treatment when the immune system is already weakened by
chemotherapy, surgery and radiation. This may limit their
effectiveness.
2. Not all antigens are the same:
All cancers may "look" the same, but they are not. Not all patients'
cancers may express the antigen against which a specific monoclonal
antibody is targeted. In general, response rates to these "targeted
therapies" appear to be around 20 to 30 percent. To optimize this
type of therapy, it will be necessary to identify each subgroup of
patients with a specific cancer and develop therapies targeted to, or
directed specifically at, their individual cancers.

20. 3. Tumour cells mutate:
as a result of chemotherapy and radiation treatment, and
therefore the target antigen on the tumour cell at which
the therapy is aimed also can be changed. If the target
changes, then the mAbs, which target those specific
antigens, could become ineffective.
4. Toxicity:
associated with some targeted therapies can be significant.

22.  Limitations of Adoptive Cell Therapy
1. Not all tumour infiltrating lymphocytes grow well
enough in culture to generate the quantity of cells that
would be required to produce a useful anti-tumour
effect when they are infused into the patient.
2. Not all tumour infiltrating lymphocytes can be made, in
culture, to become more adept at killing the tumour
upon return to the patient.
3. Autologous therapy is cumbersome and does not easily
lend itself to the commercial scale mass production
techniques necessary to reach the multitude of cancer
patients world-wide.

23.  Limitations of Cancer Vaccines
1. Today, most cancer vaccines are targeted: that means it
made against a specific tumour cell antigenic target. The
limitations of targeted vaccines are very similar to the
limitations of other targeted change, the target vaccine
becomes ineffective.
2. Not all antigen are same
3. Autologous vaccine therapy presents many
manufacturing challenges.
4. Autologous therapy is costly
5. Many cancer vaccines are poorly immunogenic and
require the use of adjuvants to elicit an effective
immune response. The addition of adjuvants may
increase immunogenicity of vaccine, but may also
increase toxicity.

25. Cancer Immunotherapy Named Science
Magazine “Breakthrough of the Year”
By Julie Grisham on Monday, December 23, 2013