Who Are the Best Candidates for Anti-cancer Immunotherapy?
In countries with a high standard of living, cancer as a cause of death is almost twice as common as cardiovascular disease, which used to top the list of death causes. Yet, cancer is not one single disease, but a group of different cancerous tumors resulting from certain cellular mutations in the human body that can form on absolutely any organ.
Each of these tumors will respond differently to treatment. With so many different options, it is difficult to make the right decision, especially when a patient tries to accept their diagnosis or believes there is only one correct treatment.
In reality, there is no “magic” treatment for all types of cancer. Often, standard therapy protocols work, but there are many cases where immunotherapy is the best treatment for the patient.
What does it mean to be a “good” candidate for cancer immunotherapy?
When recommending a particular course of treatment, doctors must look at their situation as a whole. Each decision must balance the costs and the risks of complications that a particular therapy may cause against the additional years and quality of life it may provide.
Typically, the first course of therapy is prescribed immediately after the results of a biopsy or surgery to remove the tumor. By obtaining a tumor sample, an experienced pathologist can determine the exact type of cancer the patient has developed. Once this information is obtained, combined with other factors, we will determine which treatment will give the patient the best chance of remission.
When oncologists talk about a “good” candidate, they are referring to patients who are more likely to benefit most from immunotherapy than from other cheaper or easier treatments. The choice of therapy should also be weighed against the risk of various side effects or complications, as well as the likely deterioration of the patient’s quality of life.
When does immunotherapy work best?
Anticancer immunotherapy should be considered whenever a patient faces a low chance of survival with standard chemotherapy or radiation therapy or when the harm from chemotherapy exceeds the possible benefits.
Based on clinical practice, two types of patients fall into this category.
1. Patients with known resistant mutations
Certain cancer types do not respond appropriately to standard treatments like chemotherapy or radiation therapy. In these cases, cancer cells grow too fast, preventing the tumor from shrinking when exposed to conventional therapy protocols.
In some cases, oncologists still try to use standard therapies first, either because the insurance company requires it or because it is the only option available. In these cases, conventional therapies can increase life expectancy by a few months or even a few years, despite severe side effects. However, there will still be a much higher risk of tumor re-growth or metastasis.
Patients with these types of tumors should consider immunotherapy from the beginning, either instead of chemotherapy or immediately after completing chemotherapy.
2. Patients who have developed multidrug resistance
Even if a particular cancer mutation is known to respond well to conventional treatments, there is still the possibility that it may become resistant later. This is especially likely if the initial course of chemotherapy or radiation therapy fails to completely eliminate the tumor, leaving the cancer stem cells behind.
Tumor cells that survive repeated cycles of treatment are more likely to develop resistance to multiple drugs. When this happens, further courses of chemotherapy are unlikely to do any good: they will not affect the size of the neoplasm, and the tumor will continue to spread throughout the body. Meanwhile, the patient will still feel the harmful effects of chemotherapy (side effects of the drugs), such as excessive weight loss (exhaustion), immune suppression, and general weakness.
While immunotherapy can help the patient’s immune system recognize these cancer cells and fight them independently.
Treating the person, not the diagnosis
Nowadays, many common types of cancer respond well to standard chemotherapy or radiation therapy, and it is easier for patients to undergo conventional and readily available treatments. Nevertheless, some types of cancer cannot be treated in this way. It is in these cases that immunotherapy can offer patients another way to fight cancer cells and eliminate tumors.