Immunotherapy

What is immunotherapy?

The immune system is made up of cells and organs that protect the body from threats such as infections, toxins and abnormal cell growth. The immune system recognises when a foreign organism, such as a germ, enters the body and attacks it to stop it from harming the body.

Immunotherapy, or biologic therapy, is a type of treatment that uses your own immune system to fight cancer.

Even though the immune system can prevent or slow cancer growth, cancer cells have ways to avoid destruction by the immune system. For example, cancer cells may:

have genetic changes that make them less visible to the immune system
have proteins on their surface that turn off immune cells
change the normal cells around the tumour so they interfere with how the immune system responds to the cancer cells

Immunotherapy helps the immune system to better act against cancer.

How is immunotherapy given?

How often the treatment is given will depend on the type of immunotherapy, the type of cancer, how advanced the cancer is, how the cancer responds to treatment or the side effects you experience. Different forms of immunotherapy may be given in different ways, including orally, directly into a vein through an intravenous injection or infusion (IV), by applying a cream, directly into the bladder, or injected into a tumour.

How much does immunotherapy cost?

As your treatment is unique to you and your clinical circumstances, a consultation is usually required to give a single and accurate answer to this question. However, there is some key information to remember.

If choosing to be treated by a private provider such as Icon Cancer Centre, private health insurance is required. In Australia, out-of-pocket treatment costs, if any, will depend on your health insurance policy level of cover. At Icon, we have no-gap agreements with most private health funds—this means no out-of-pocket costs—for admitted Medicare Benefits (MBS) services.

Reach out to our team at your nearest Icon Cancer Centre to discuss the cost of immunotherapy treatment.

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What types of cancer can be treated with immunotherapy?

Since its introduction in 1891, immunotherapy has evolved significantly, including multiple different types of therapies which help the body’s immune system to fight cancer, such as cancer vaccines, monoclonal antibodies, checkpoint inhibitors and Chimeric antigen receptor (CAR) T-cell therapies. Once limited in availability, immunotherapy Australia now includes access to many approved therapies under the Pharmaceutical Benefits Scheme (PBS) for a broader range of cancers.

In Australia, immunotherapy is currently TGA approved for use for the following cancer types:

Acute lymphoblastic leukaemia (ALL)
Bladder cancer
Colorectal cancer (deficient in mismatch repair proteins)
Cervical cancer
Chronic lymphocytic leukaemia (CLL)
Head and neck cancer
Hepatocellular cancer (liver cancer)
Kidney cancer
Lung cancer
Lymphoma
Melanoma skin cancer
Myeloma
Non-melanoma skin cancer (cutaneous squamous cell carcinoma and merkel cell carcinomas)
Oesophageal cancer
Triple negative breast cancer

Following several landmark clinical trials globally, immunotherapy has expanded to treat a much broader range of cancer types. Immunotherapy is most commonly used to treat advanced cancers that have spread beyond the area where the cancer first developed, known as secondary or metastatic cancers, and recurrent cancer (when cancer returns after treatment).

As we better understand how cancers grow and multiply, new discoveries are being made and more immunotherapy treatments are becoming available every day.

Immunotherapy can work more effectively when used in combination with other anti-cancer treatments such as chemotherapy and radiotherapy, and many commonly used treatment plans combine these cancer therapies.

What are the side effects of immunotherapy?

Immunotherapy side effects can affect people in different ways and will depend on how healthy you are before treatment, your type of cancer, how advanced it is, the type of therapy you are getting, and the dose.

The most common side effects are skin reactions at the needle site, which can include pain, swelling, soreness, redness, itchiness and a rash. You may experience flu-like symptoms, such as fever, chills, weakness, dizziness, nausea or vomiting, muscle or joint aches, fatigue, headache, trouble breathing, and low or high blood pressure.

Other side effects might include swelling and weight gain from fluid retention, heart palpitations, sinus congestion, diarrhoea and risk of infection. Immunotherapy can cause side effects, many of which happen when the immune system that has been revved up to act against the cancer also act against healthy cells and tissues in your body.

Rarer side effects of some immunotherapies, such as immune checkpoint inhibitors can include widespread inflammation.

Depending on the organ of your body that is affected, inflammation can lead to:

changes in skin colour, rash, and feeling itchy, caused by skin inflammation
cough and chest pains, caused by inflammation in the lungs
belly pain and diarrhoea, caused by inflammation in the colon
diabetes, caused by inflammation in the pancreas
hepatitis (inflammation of the liver)
hypophysitis (inflammation of the pituitary gland)
myocarditis (inflammation of the heart muscle)
nephritis (inflammation of the kidney) and impaired kidney function
overactive or underactive thyroid
nervous system problems such as muscle weakness, numbness, and trouble breathing

Frequently asked questions

Cancer cells learn to survive and grow in a hostile environment due to their ability to hide from the immune system and avoid detection by the body’s own self defences. Once the immune system is alerted and activated, other healthy cells may be recognised as different and vulnerable to attack by the body’s own defence systems. This is what causes some of the side effects of immunotherapy.
If you have an autoimmune disorder such as rheumatoid arthritis, lupus, ulcerative colitis, or Crohn’s disease, be sure to inform your cancer specialist. Immunotherapy might still be an option, but there are additional considerations.
Autoimmune disorders cause the immune system to become overactive, attacking healthy cells and leading to inflammation. The heightened immune response from immunotherapy can worsen these symptoms.
Consult with your specialists if you’ve undergone an organ transplant. You are likely on medications that suppress your immune system to prevent organ rejection; the right balance between these medications will need to be established alongside the increased immune activity from immunotherapy treatment.
Icon Cancer Centre provides private immunotherapy treatment at a number of locations across Australia. Reach out to our team at your nearest centre to discuss your treatment options.
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While immunotherapy can offer successful treatment for many people, it’s important to remember that it isn’t always a cure-all and doesn’t work for everyone. Immunotherapy isn’t effective for all types of cancers and, in some people, immunotherapy may not work or may stop working after a period of time.
If your immunotherapy stops working, other options may include different immunotherapy drugs, combination treatments like immunotherapy with chemotherapy or radiation, or alternative anti-cancer therapies. Your doctor may recommend adding a new drug to improve the effectiveness of your current treatment.