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DEFINATION:- Immunotherapy is a medical termdefined as treatment of disease by inducing, enhancing,
or suppressing an immune response .
Immunotherapies designed to elicit or amplify an
immune response are classified as activation
immunotherapies.Immunotherapies designed to reduce, suppress or
more appropriately direct an existing immune
response ,as in cases of autoimmunity or allergy, are
classified as suppression immunotherapies
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The active agents of immunotherapy are collectively
called immunomodulators.
They are a diverse array of recombinant, synthetic
and natural preparations, often cytokines. Some of
these substances, such as granulocyte colony -
stimulating factor (G-CSF), interferons, imiquimod and
cellular membrane fractions from bacterial
microorganisms are already licensed for use in
patients.
Others including IL-12, various chemokines,
cytosine phosphate-guanosine (oligodeoxynucleotides
and glucans are being currently investigated
extensively in clinical and preclinical studies.
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Cell based Immunotherapies are proven to be
effective for cancers, where the immune cells such
as lymphocytes, macrophages, dendritic cells,
natural killer cells (NK Cell), cytotoxic T
lymphocytes (CTL), etc., work together to defend
the body against cancers and attacks by "foreign"
or "non-self" invaders such as bacteria and
viruses.
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Cancer immunotherapy attempts to stimulate the
immune system to reject and destroy tumors.
cancer
Immuno cell therapy for cancer was first introduced
by Rosenberg and his colleagues of NationalInstitute of Health USA. In the late 80s, they
published an article in which they reported a low
tumor regression(2.63.3%) in 1205 patients with
metastatic cancer who underwent different types ofactive specific immunotherapy (ASI), and suggested
that immuno cell therapy with specific chemotherapy
is the future of cancer immunotherapy.
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In the beginning Immunotherapy treatmentsinvolved administration of cytokines such as
Interleukin with an aim of inducing the lymphocytes
to carry on their activity of destroying the tumor
cells.
Thereafter the adverse effects of such
intravenously administered cytokine
lead to the extraction of the lymphocytes from theblood and culture-expanding them in the lab and
then injecting the cells alone to enable them to
destroy the cancer cells.
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Though the concept of this treatment started in
the US in 80s, fully fledged clinical treatments on a
routine basis have been in practice in Japan since
1990. Randomized controlled studies in different
cancers with significant increase in survival and
disease free period have been reported.
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Lung cancer has been demonstrated to potentially
respond to immunotherapy
In many parts of Asia, medicinal mushrooms are
thought to be able to boost the immune system naturally.
Cellular and animal research has shown that Agaricusblazei may stimulate immune system cells and the
production of interferons and interleukins (reviewed by
G. Hetland).
Mushroom isolates like PSK also are used to increase
immune system parameters (reviewed by Kobayashi).
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Autologous Immune Enhancement Therapy (AIET)
In the multipronged approach to treat cancer,one very useful latest weapon would be AIET
which is in clinical practice in Japan since 90s
AIET is a treatment method in which some
immune cells are taken out of a patient's body
which are cultured and processed to be
activated or to acquire additional functions until
their resistance to cancer is strengthened, then
the cells are put back in the body.
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. Researchers have found that the thus activated
immune system might also be able to determine the
difference between healthy cells and cancer cells
eliminate the cancer cells from the body.
In AIE
T, specific type of cells mainly the NK cellsand lymphocytes are isolated from the peripheral
blood of the cancer patients (during remission in
patients who undergo chemotherapy)
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These cells are act against cancer cells and active immuneresponse.
Upon encountering a tumor cell, the activated NK cell attaches
to the membrane of the cancer cell and injects toxic granules
which dissolve the target cell. In less than five minutes, the
cancer cell dies and the NK cell moves on to its next target
cancer cell. A single NK cell can destroy up to 27 cancer cells
before its lifespan. This is the mechanism by which AIET is
effective in Cancer therapy.
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Dendritic cell based immunotherapy
This utilizes dendritic cells to activate a cytotoxic
response towards an antigen.
Dendritic cells, a type of antigen presenting cell ,
are harvested from a patient. These cells are then
either pulsed with an antigen or transfected with a
viral vector. The activated dendritic cells are then
placed back into the patient
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Monoclonal antibody therapy
Antibodies are a key component of the adaptive immune
response playing a central role in both in the recognition of
foreign antigens and the stimulation of an immune response
to them.It is not surprising therefore, that many
immunotherapeutic approaches involve the use of
antibodies.
The advent of monoclonal antibody technology has made it
possible to raise antibodies against specific antigens such as
the unusual antigens that are presented on the surfaces of
tumors.
A number of therapeutic monoclonal antibodies have been
approved for use in humans; approvals mentioned here are
by the U.S.Food and Drug Administration(FDA).
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Cancer immunotherapy:Monoclonal antibodies[1]
Antibody Brand name Approval date Type TargetApproved
treatment(s)
Alemtuzumab Campath 2001 humanized CD52
Chronic
lymphocytic
leukemia
Bevacizumab Avastin 2004 humanized
vascular
endothelial
growth factor
colorectal cancer
Cetuximab Erbitux 2004 chimeric
epidermal
growth factor
receptor
colorectal cancer
Gemtuzumab
ozogamicinMylotarg 2000 humanized CD33
acute
myelogenous
leukemia
calicheamicin
Ibritumomab
tiuxetan Zevalin 2002 murine CD20
non-Hodgkin
lymphomayttrium-90
Panitumumab Vectibix 2006 human
epidermal
growth factor
receptor
colorectal cancer
RituximabRituxan,
Mabthera1997 chimeric CD20
non-Hodgkin
lymphomaTrastuzumab Herceptin 1998 humanized ErbB2 breast cancer
).
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The therapy is indicated for people who are
extremely allergic or who cannot avoid specificallergens.
Immunotherapy is generally not indicated for food
or medicinal allergies. Immunotherapy is typicallyindividually tailored and administered by an allergist
(allergologist)This therapy is particularly useful for
people with allergic rhinitis or asthma.
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Other approaches to immunotherapy
Recent research into the clinical effectiveness of
Whipworm ova (Trichuris suis) and Hookworm
(Necator americanus) for the treatment of certain
immunological diseases and allergies means thatthese organisms must be classified as immuno-
therapeutic agents.
Helminthic therapy is being investigated as apotentially highly effective treatment for the symptoms
and or disease process in disorders such as relapsing
remitting multiple sclerosis Crohn s,
allergies and asthma.
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Cancer Vaccines Back to the Table of Contents As described above,
biological therapy or immunotherapy is now
considered a fourth modality of cancer treatment, and
examples such as interferon and monoclonal
antibodies have become part of standard cancer
treatment.
Vaccines have revolutionized public health by
preventing the development of many important
infectious diseases, including polio, small pox, and
diphtheria. It has been much more difficult to develop
effective vaccines to prevent cancer, or to treat
patients who already have cancer.
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. Attempts to develop such cancer vaccines,
despite many decades of experimental work, haveyet to yield proven results.
Cancer vaccines typically consist of a source of
cancer-associated material (antigen), along withother components, to further stimulate the immune
response
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cancer vaccines have been shown to be capable
of improving the immune response againstparticular antigens.
The result of this immunologic effect is not always
sufficient to reverse the progression of cancer.
However, cancer vaccines have been generally
well tolerated, and they may provide useful
anticancer effects in some situations.
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