Immunotherapy

Introduction

The immune system is made up of cells, tissues and organs in the body that work to:

• fight germs, illness and infection
• heal injuries and recover from sickness
• recognise and remove dead, damaged or abnormal cells.

Immunotherapy is a type of cancer treatment that helps a person's immune system destroy or slow the growth of cancer cells. This treatment may also help the immune system improve how it fights cancer cells.  

Immunotherapy is usually given alongside other types of cancer treatment, including:

• chemotherapy
• radiotherapy. 

Immunotherapy is generally only used to treat specific types of cancer, including:

• leukemia
• lymphoma
• kidney cancer. 

It is not generally used as a first-line treatment for cancer in children but may be looked at if general cancer treatments are not working well. 

Immunotherapy can work by improving the immune system's ability to fight cancer and removing any barriers stopping the immune system from attacking cancer properly.

There are many different kinds of immunotherapies, each working differently.

Some ways that immunotherapies work include:

• substances that attach to cancer cells and tell the immune system to destroy them
• blocking cancer cells and slowing their growth
• carrying chemotherapy or radiotherapy directly to the cancer cells
• exposing cancer cells that are hidden from the immune system
• stimulating the immune system and boosting the ability to attack cancer cells
• using viruses to trigger an immune system response.

Your child's treating team will: 

• discuss immunotherapy options and whether it is suitable for your child’s cancer treatment
• decide which type of immunotherapy to use
• order tests and checks to make sure your child is healthy enough for treatment.

Immunotherapy is usually an outpatient treatment. Your child will visit the hospital for treatment and go home afterwards.

The type of immunotherapy given will depend on the type of cancer being treated and the type of immunotherapy used.

Immunotherapy can be given by:

• intravenous (IV) cannula - a thin tube is inserted into the vein
• oral or by mouth – tablets, capsules or liquids that are swallowed 
• topical or on the skin – creams rubbed into the skin. 

During immunotherapy, your child will have regular check-ups that include: 

• talking about how they feel during treatment
• physical examinations
• blood tests
• scans to measure the tumour.

Children with cancer will have regular checkups with their doctors after treatment is finished.

This is to monitor:

• how your child is recovering from treatment
• whether the treatment worked
• whether any further treatment is needed.

After the first few years, follow-up appointments will change to monitoring:

• growth
• development 
• long-term or late side effects from treatment. 

There is often a delayed response to immunotherapy, so it can take time to know if the treatment has worked.

In some cases, the cancer will be stable. This means it does not grow but does not shrink or go away. Children with stable cancer can have a good quality of life.