April 3, 2020

Immunotherapy in India: How it Works & Pros and Cons

Published: May 20, 2019. Updated: August 30, 2019. Updated: April 18, 2020.

Credited to Memorial Sloan Kettering Cancer Center: https://www.mskcc.org/videos/immunotherapy-how-it-works

What is Immunotherapy? Is Immunotherapy in India used for Cancer Patients?

Immunotherapy is a new treatment option in the fight against cancer. It enables the body’s own immune system to detect and then fight cancer. Immunotherapies have been launched only recently in India but are increasingly used in cancer care. Here’s what you need to know. Testing for immunotherapy benefits has been launched in 2017 by Positive Bioscience.

Types of Immunotherapy in Laymen Terms:

Treatment vaccines – these are different from normal vaccines as they work with the immune system to fight cancer cells.
Monoclonal antibodies – also known as therapeutic antibodies, are immune system proteins produced in the lab. They “mark” cancel cell so the immune system would identify them and then attack them.
Adoptive cell transfer – treatment to increase natural ability of T-cells to fight tumor.
Checkpoint inhibitors – drugs that are used to release “breaks” that would keep T cells from killing cancer. These drugs do not target the tumor directly. Instead, they interfere with the ability of cancer cells to avoid immune system attack.

Pros of Immunotherapy in India

✓ Used in first-line or second-line treatment failures

India has experienced a surge in the use of immunotherapy not after multiple lines of failure where options are scarce, but are increasingly used in first-line or second-line failures, which is earlier in the treatment cycle. This is great for patients who have been responded to initial therapies to maximize their chance of responding to immunotherapy.

ALSO READ: Approaches for Tumor Mutation Burden estimation

✓ Immunotherapy is recommended by cancer treatment guidelines

Immunotherapy is now recommended by many leading international cancer treatment guidelines, including NCCN. NCCN guidelines are very popular and followed by many Indian doctors. NCCN guidelines also recommend tumor mutation burden testing.

✓ Can work where other treatments have failed

When conventional treatments like chemotherapy have failed, immunotherapy provides another path for a patient to receive treatment options, thereby greatly increasing the chances of finding an option that works.

Cons of Immunotherapy in India

✘ It does not work in every patient

While proven effective and clinically beneficial, and even game-changing in certain patients, not every patient will respond. In fact, the majority of patients, will not show any benefit. Some studies estimate that only 20% – 30% of patients will benefit. In rare cases, immunotherapy has the opposite of the intended effect, and sends the cancer into overdrive.

✘ Data is still emerging

Unlike chemotherapy, where all the pros and cons are widely known, immunotherapy is a newer cancer treatment option. Data is still emerging to decide for which cancer types, in what stage/setting, where in the treatment cycle and what testing is required. As more data is available immunotherapy facts will become clear.

✘ It’s expensive and not every option is available in India

Immunotherapy is among the most expensive cancer treatments available and can easily cost over Rs. 10 lakh (based on data from our patients). Currently not many (if any) generic versions are available to provide cheaper options for patients. Planning your finances carefully. Additionally, not every immunotherapy option is available in India.

How are Immunotherapies given?

Intravenous (IV) – immunotherapy goes into vein
Oral – pills or capsules that you swallow.
Topical – in form of a cream that you rub onto your skin (mainly for skin cancer).
Intravesical – goes directly into the bladder.

Immunotherapy in India: Is it Available?

Yes. Launched around 2017, immunotherapy has become increasingly popular in India. Indian cancer patients tend to be late stage where immunotherapy has a wider role to play. Not all the options available in America are available in India but at the time of this writing around three options are available in India.

Tests which can Help you Decide on Immunotherapy:

References: