|
Biological Therapy
..................................................................................................................................................
Biological
therapy (also called immunotherapy, biological response modifier therapy, or
biotherapy) uses the body's immune system to fight cancer.
The cells, antibodies, and
organs of the immune system work to protect and defend the body against
foreign invaders, such as bacteria or viruses. Physicians and researchers
have found that the immune system might also be able to both determine the
difference between healthy cells and cancer cells in the body, and to
eliminate the cancer cells.
Biological therapies are
designed to boost the immune system, either directly or indirectly, by
assisting in the following:
¢
Making cancer cells more recognizable by the immune system, and therefore
more susceptible to destruction by the immune system.
¢
Boosting the killing power of immune system cells.
¢
Changing the way cancer cells grow, so that they act more like healthy
cells.
¢
Stopping the process that changes a normal cell into a cancerous cell.
¢
Enhancing the body's ability to repair or replace normal cells damaged or
destroyed by other forms of cancer treatment, such as chemotherapy or
radiation.
¢
Preventing cancer cells from spreading to other parts of the body.
The immune system includes
different types of white blood cells - each with a different way to fight
against foreign or diseased cells, including cancer:
¢ lymphocytes
-
white blood cells, including B cells, T cells, and NK cells.
- B cells
-
produce antibodies that attack other
cells.
- T cells
-
directly attack cancer cells themselves
and signal other immune system cells to defend the body.
- natural
killer cells (NK cells) -
produce chemicals that bind to and kill
foreign invaders in the body.
¢ monocytes
-
white blood cells that swallow and digest foreign particles.
¢ dendritic
cells -
present the foreign cells to the immune
system.
These types of white blood
cells - B cells, T cells, natural killer cells, and monocytes - are in the
blood and thus circulate to every part of the body, providing protection
from cancer and other diseases. Cells secrete two types of substances:
antibodies and cytokines.
Antibodies respond to
(harmful) substances that they recognize, called antigens. Specific
(helpful) antibodies match specific (foreign) antigens by locking together.
Cytokines are proteins produced by some immune system cells and can directly
attack cancer cells. Cytokines are "messengers" that "communicate" with
other cells.
There are many different
types of biological therapies used in cancer treatment.
Biological response
modifiers (BRMs) change the way the body's defenses interact with cancer
cells. BRMs are produced in a laboratory and given to patients to:
¢
Boost the body's ability to fight the
disease.
¢
Direct the immune system's disease
fighting powers to disease cells.
¢
Strengthen a weakened immune system.
BRMs include nonspecific
immunomodulating agents, interferons, interleukins, colony-stimulating
factors, monoclonal antibodies, cytokine therapy, and vaccines:
¢
Nonspecific
immunomodulating agents
Nonspecific immunomodulating agents are biological therapy drugs
that stimulate the immune system, causing it to produce more cytokines and
antibodies to help fight cancer and infections in the body. Fighting
infection is important for a person with cancer.
¢
Interferons (IFN)
Interferons (IFN) are a type of biological response modifier that
naturally occurs in the body. They are also produced in the laboratory and
given to cancer patients in biological therapy. They have been shown to
improve the way a cancer patient's immune system acts against cancer
cells. Interferons may work directly on cancer cells to slow their growth,
or they may cause cancer cells to change into cells with more normal
behavior. Some interferons may also stimulate natural killer cells (NK)
cells, T cells, and macrophages - types of white blood cells in the
bloodstream that help to fight cancer cells.
¢
Interleukins (IL)
Interleukins (IL) stimulate the growth and activity of many immune cells.
They are proteins (cytokines) that occur naturally in the body, but can
also be made in the laboratory. Some interleukins stimulate the growth and
activity of immune cells, such as lymphocytes, which work to destroy
cancer cells.
¢
Colony-stimulating
factors (CSFs)
Colony-stimulating factors (CSFs) are proteins given to patients to
encourage stem cells within the bone marrow to produce more blood cells.
The body constantly needs new white blood cells, red blood cells, and
platelets, especially when cancer is present. CSFs are given, along with
chemotherapy, to help boost the immune system. When cancer patients
receive chemotherapy, the bone marrow's ability to produce new blood cells
is suppressed, making patients more prone to developing infections. Parts
of the immune system cannot function without blood cells, thus
colony-stimulating factors encourage the bone marrow stem cells to produce
white blood cells, platelets, and red blood cells. With proper cell
production, other cancer treatments can continue enabling patients to
safely receive higher doses of chemotherapy.
¢
Monoclonal antibodies
Monoclonal antibodies are agents, produced in the laboratory, that bind to
cancer cells. When cancer-destroying agents are introduced into the body,
they seek out the antibodies and kill the cancer cells. Monoclonal
antibody agents do not destroy healthy cells.
Examples of monoclonal antibody therapy include trastuzumab (Herceptin®)
for breast cancer and rituximab (Rituxan®) for lymphoma.
¢
Cytokine therapy
Cytokine therapy uses proteins (cytokines) to help your immune system
recognize and destroy those cells that are cancerous. Cytokines are
produced naturally in the body by the immune system, but can also be
produced in the laboratory. This therapy is used with advanced melanoma
and with adjuvant therapy (therapy given after or in addition to the
primary cancer treatment). Cytokine therapy reaches all parts of the body
to kill cancer cells and prevent tumors from growing.
¢
Vaccine therapy
Vaccine therapy is still an experimental biological therapy. The benefit
of vaccine therapy has not yet been proven. With infectious diseases,
vaccines are given before the disease develops. Cancer vaccines, however,
are given after the disease develops, when the tumor is small. Scientists
are testing the value of vaccines for melanoma and other cancers.
Sometimes, vaccines are combined with other therapies such as cytokine
therapy.
As each person's individual
medical profile and diagnosis is different, so is his/her reaction to
treatment. After effects may be severe, mild, or absent. Be sure to discuss
with your cancer care team any/all possible after effects of treatment before
the treatment begins.
After effects of biological
therapy, which often mimic flu-like symptoms, vary according to the type of
therapy given and may include the following:
¢
Fever
¢Chills
¢
Nausea
¢
Vomiting
¢
Loss of appetite
¢
Fatigue
Specifically, cytokine
therapy often causes fever, chills, aches, and fatigue. Other after effects
include a rash or swelling at the injection site. Therapy can cause fatigue
and bone pain and may affect blood pressure and the heart.
|