1

KINGDOM OF BAHRAIN

CERTIFICATE OF COMPLETION

This is to certify that Nihira Sandeep Naik of class XII-B

has successfully completed the BIOLOGY project on

the topic

“STUDY OF IMMUNOTHERAPY INFLUENCE ON THE HUMAN BODY” for the

academic year 2023-2024.

Internal Examiner: School Seal:

External Examiner:

2
 ACKNOWLEDGMENTs

I take this opportunity to express my gratitude and thank my

teacher, Mrs. Krishnapriya Sudeep, for her guidance and constant
supervision and also providing necessary information regarding the
project as well as the Principal who gave me the golden opportunity
to work on this wonderful project, which was based on the topic
“STUDY OF IMMUNOTHERAPY INFLUENCE ON THE HUMAN
BODY” which also helped me explore the topic and in the process,
learnt many new things.
I hope that my project creates a meaningful impact and once again,
thank you to all.

3
 INDEX

Introduction

What is Immunotherapy?

Immunotherapy’s Mechanism Against Cancer

Types of Cancers

Ways in Which Immunotherapy is Given

Side Effects of Immunotherapy

Cancers Treated by Immunotherapy

Benefits and Risks of Immunotherapy

Difference between Immunotherapy and Chemotherapy

Combining Chemotherapy and Immunotherapy

Cancer Treatment Vaccines

Conclusion

4
 OBJECTIVES

 To discuss the relevancy of immunotherapy at present and to

write a thorough report on the overall idea.

 To learn more about immune cells and to investigate the scope of

this industry.

 To elucidate the pros and cons of immunotherapy in cancer

treatments.

5
IMMUNOTHERAPY:-
Immunotherapy is a type of cancer treatment. It uses substances made by the
body or in a laboratory to boost the immune system and help the body find
and destroy cancer cells.

Immunotherapy can treat many different types of cancer. It can be used alone
or in combination with chemotherapy and/or other cancer treatments.

Immunotherapy is a type of biological therapy. Biological therapy is a type of

treatment that uses substances made from living organisms to treat cancer. As
part of its normal function, the immune system detects and destroys abnormal
cells and most likely prevents or curbs the growth of many cancers. For
instance, immune cells are sometimes found in and around tumors. These
cells, called tumor-infiltrating lymphocytes or TILs, are a sign that the immune
system is responding to the tumor. People whose tumors contain TILs often
do better than people whose tumors don’t contain them.

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 tumor so they interfere with
how the immune system responds to the cancer cells.

Immunotherapy helps the immune system to better act against cancer.

Immunotherapy drugs have been approved to treat many types of cancer.

However, immunotherapy is not yet as widely used as surgery, chemotherapy,
or radiation therapy.

Immunotherapy uses our immune system to fight cancer. It works by helping

the immune system recognize and attack cancer cells.

You might have immunotherapy on its own or with other cancer

treatments. Immunotherapy is a standard treatment for some types of
cancer. And it is in trials for other types of cancer.

6
There are different types of immunotherapy. These include monoclonal
antibodies, checkpoint inhibitors, and vaccines. Some types of immunotherapy
are also called targeted treatments or biological therapies.

IMMUNOTHERAPY’S MECHANISM AGAINST

CANCER :-
Your immune system’s everyday job is to protect your body from intruders,
from allergens and viruses to damaged cells that could become cancerous. It
has special cells that constantly patrol your body for intruders. When they
find a damaged or cancerous cell, they destroy it. That keeps cancerous
tumors from growing and spreading. But cancer is a moving target. Cancerous
cells constantly look for ways to dodge immune system defenses.
Immunotherapy works by:

 Training your immune system so it can do more to find and kill cancer
cells.
 Helping your body produce cancer-fighting immune cells that effectively
locate and destroy cancer cells.

Healthcare providers consider immunotherapy a first-line or initial treatment

for many types of metastatic cancer, or cancer that’s spread. They may
combine immunotherapy with chemotherapy, targeted therapy or other
cancer treatments. Providers use different types of immunotherapy to treat
many kinds of cancer. Each immunotherapy type uses different elements of
your immune system.

TYPES OF IMMUNOTHERAPY :-
CHECKPOINT INHIBITORS :-
Your immune system is a powerful defense system — sometimes too
powerful. Your body has checkpoints to keep your immune system from
overreacting to intruders and damaging healthy cells.

For example, your bone marrow makes white blood cells called T
lymphocytes, or T-cells. T-cells protect your body from infection and tackle

7
cancer cells. Immune checkpoints connect with proteins on the surface of T-
cells

Checkpoint proteins and other proteins manage the flow of signals to T-cells,
telling the cells when to turn off and on. (Think traffic monitors that manage
traffic flow by switching traffic lights off and on.) T-cells turn on to kill
cancerous cells. They turn off so they don’t damage normal cells.

Checkpoint inhibitors are immunotherapy drugs that work by breaking the

connection between the checkpoint proteins and other proteins. Breaking the
connection keeps protein cells from telling T-cells to turn off. That way, T-cells
keep on killing cancerous cells.

Healthcare providers typically use checkpoint inhibitors to treat many

different types of cancer. In general, providers use checkpoint inhibitors to
treat advanced cancer, cancer that’s spread, cancer that can’t be treated with
surgery or cancer that hasn’t responded to other treatments. They may
combine checkpoint inhibitor drugs with other treatments, including
chemotherapy or targeted therapy. The list below is expected to grow as
medical researchers find ways to use immunotherapy to treat many more
kinds of cancer:

 Bladder cancer.
 Cervical cancer.
 Esophageal cancer.
 Head and neck cancer.
 Hepatocellular carcinoma.
 triple-negative breast cancer.
 Kidney cancer.
 Melanoma.
 Mesothelioma.
 Non-small cell lung cancer.

ADOPTIVE CELL THERAPY :-

This treatment improves your immune system’s ability to destroy cancerous
cells. Healthcare providers take your immune cells and grow them in a
laboratory. Once your cells have grown, providers insert the cells back into
your body so they can kill cancerous cells. CAR T-cell therapy and tumor-
infiltrating lymphocyte therapy are the two main types of T-cell transfer
therapy
8
Chimeric antigen receptor (CAR) T-cell therapy works by turning your T
lymphocytes, or T-cells, into more efficient cancer-fighting machines. Your T-
cells are white blood cells in your immune system. Your immune system
monitors your body for intruders, such as cancerous cells, by tracking
proteins called antigens that are located on the surface of intruder cells. Your
immune system relies on T-cells to track and kill intruders.

Your T-cells have their own proteins called receptors. Receptors are like the
anti-virus software on your computer. When your T-cell security team senses
intruder antigens, they use their receptors to catch and block the intruders.
More than that, your T-cells can kill the intruders. But antigens have their own
form of protection. They can disguise themselves to hide from your T-cells.
CAR T-cell therapy ensures your T-cells aren’t fooled by antigens in disguise.

CAR T-cell therapy treats certain blood cancers, including some types
of leukemia, lymphoma and multiple myeloma. Medical researchers are
investigating CAR T-cell therapy as a way to treat breast cancer and brain
cancer.

MONOCLONAL ANTIBODY THERAPY :-

Antibodies are part of the first line of defense when your immune system
detects intrudes. Antibodies are proteins that fight infection by marking
intruders so your immune system will destroy them. Monoclonal antibody
therapy for cancer involves lab-made antibodies that can support your
existing antibodies or become their own attack force.

The lab-made antibodies may attack parts of a cancerous cell. For example,
they may block abnormal proteins in cancerous cells. Monoclonal
antibodies can also target cancerous cells for special delivery of drugs, toxins
or radioactive material that can kill cancerous cells. (Healthcare providers
consider monoclonal antibody therapy a form of targeted therapy. In targeted
therapy, providers target a cancer’s specific genes, proteins or the tissues
where tumors are growing.)

The FDA has approved more than 60 different monoclonal antibody drugs
that treat a wide range of cancer. Common types of cancer treated by different
monoclonal antibodies include:

 Bladder cancer.
 Breast cancer, including triple-negative breast cancer.
9
  Colorectal cancer.
 Lymphomas, including non-Hodgkin lymphoma, cutaneous T-cell
lymphoma and B-cell lymphoma.
 Leukemia, including acute lymphoblastic leukemia, hairy cell leukemia,
acute myeloid leukemia and chronic lymphocytic leukemia.
 Multiple myeloma.
 Non-small cell lung cancer.

THE SIDE EFFECTS OF IMMUNOTHERAPY :-

Immunotherapy can cause side effects. Many side effects happen when the
immune system that is revved-up to act against the cancer also acts against
healthy cells and tissues in the body.

Different people have different side effects. The ones you have and how they
make you feel will depend on

 how healthy you are before treatment

 your type of cancer
 how advanced your cancer is
 the type and dose of immunotherapy you are getting

You might be on immunotherapy for a long time. And side effects can occur at
any point during and after treatment. Doctors and nurses cannot know for
certain when or if side effects will occur or how serious they will be. So, it is
important to talk with your doctors and nurses about what signs to look for
and what to do if you start to have problems.

Some side effects are common with all types of immunotherapy. For instance,
you might have skin reactions at the needle site, which include:

10
Investigating Cancer Immunotherapy Side Effects
Researchers aim to better understand, manage the side effects of these new
drugs, such as:

 pain
 swelling
 soreness
 redness
 itchiness
 rash

You may have flu-like symptoms, which include:

 fever
 chills
 weakness
 dizziness
 nausea or vomiting
 muscle or joint aches

11
  fatigue
 headache
 trouble breathing
 low or high blood pressure

Other side effects might include:

 swelling and weight gain from retaining fluid

 heart palpitations
 sinus congestion
 diarrhea
 infection
 organ inflammation

Some types of immunotherapy may cause severe or fatal allergic and

inflammation-related reactions. But, these reactions are rare.

Certain side effects might happen depending on the type of immunotherapy

you receive. Visit the page for the type of immunotherapy that you are
receiving for more details about serious side effects. Types of immunotherapy
include:

 immune checkpoint inhibitors

 t-cell transfer therapy
 monoclonal antibodies
 treatment vaccines
 immune system modulators

12
WHICH CANCERS ARE TREATED BY THE SAME :-
BLADDER CANCER:

Today, there are six FDA-approved options for bladder cancer. They include:

 Targeted antibodies. This type of treatment disrupts cancer cells and

alerts the immune system to target and kill them.
 Cancer vaccines. They help your body kill or stop cancer cells or keep
them from coming back.
 Immune system modulators, which boost your overall immune
response. Checkpoint inhibitors are one example.

Immunotherapy treatments have been approved or are being tested for more
than 20 kinds of cancers.

BRAIN CANCER:

There are two approved types of targeted antibodies for brain and nervous
system cancers. Researchers are testing several others in clinical trials to find
out if immunotherapy might work where other treatments have failed.

BREAST CANCER:

At first, doctors thought immunotherapy was a poor option for breast cancer.
But newer studies suggest that certain women may benefit from it. They
include women who make too much of a protein receptor called HER2. Several
types of targeted antibodies take aim at the HER2 pathway. In 2019, the FDA
also approved the first checkpoint inhibitor for breast cancer.

CERVICAL CANCER:

Doctors use three cancer vaccines to treat cervical cancer. The FDA also
approved one checkpoint inhibitor and one monoclonal antibody, a type of
targeted therapy.

CHILDHOOD CANCER:

There are several approved immunotherapy options for childhood cancer,

such as certain types of leukemia, lymphoma, and brain cancer. These include:

 Targeted antibodies

13
  Checkpoint inhibitors
 Adoptive cell therapy such as CAR T-cell therapy, where your own T-
cells are genetically modified to help your immune system find and
destroy cancer cells

COLORECTAL CANCER:

Several targeted therapies and checkpoint inhibitors are used for this cancer.
These may work best for patients with certain genetic traits.

ESOPHAGAL CANCER:

The FDA has approved two targeted therapies and one checkpoint inhibitor
for this type of cancer. Researchers are looking at these ways to unleash
immunotherapy against esophageal cancer:

 Use it before other types of treatment.

 Combine it with other therapies.
 Try to keep it from coming back.

HEAD AND NECK CANCER:

Immunotherapy may be especially helpful for people with human

papillomavirus (HPV)-related head and neck cancers. It may also help avoid
the intense side effects of other types of treatment. The FDA has approved one
targeted antibody and two checkpoint inhibitors for these cancers.

KIDNEY CANCER:

Researchers are paying a lot of attention to this cancer. The first options used
for kidney cancer were targeted therapies and cytokines, which are proteins
made by white blood cells that spur your immune system to kill cancer cells.
The FDA has also approved a monoclonal antibody and checkpoint inhibitors.

LEUKEMIA:

Here are several approved immunotherapy options for this blood cancer.
These include:

 Targeted antibodies
 Adoptive cell therapy
 Cytokines

14
LIVER CANCER:

The hepatitis virus is a major cause of this cancer. The hepatitis B vaccine was
the first vaccine developed to prevent cancer. We don’t have a vaccine yet for
hepatitis C (HCV). But antiviral drugs that treat HCV may keep liver cancer
from starting. Doctors can also use two types of checkpoint inhibitors for this
cancer.

LUNG CANCER:

Immunotherapy, used alone or with other types of treatment, has made a big
difference for people with cancer in their lungs. Today, targeted therapies and
checkpoint inhibitors may even be used ahead of treatments such as
chemotherapy.

LYMPHOMA:

Immunotherapy is used to treat this blood cancer for adults and children. This
includes:

 Targeted antibodies
 Checkpoint inhibitors
 Cytokines
 Adoptive cell therapy

MELANOMA:

Checkpoint inhibitors raise survival rates for some people with an advanced
form of this skin cancer. Doctors sometimes also use cytokines and oncolytic
virus therapy for this type of cancers.

MULTIPLE MYELOMA:

Several monoclonal antibodies are used to treat this blood cancer. Doctors
may use them after a stem cell transplant to help keep cancer at bay.

OVARIAN CANCER:

One monoclonal antibody is available now. But many immunotherapy trials

are underway for this type of deadly cancer.

15
PANCREATIC CANCER:

This cancer has few good treatments. Researchers are working hard to
explore immunotherapy in trials. In the meantime, doctors may use a
checkpoint inhibitor for patients whose cancer cells have certain genetic
traits.

PROSTATE CANCER:

A cancer vaccine and a checkpoint inhibitor are available to treat some

advanced cases of prostate cancer.

SARCOMA:

This is a rare kind of cancer that starts in your bones or soft tissue. One type of
monoclonal antibody is used to treat sarcoma. As with many cancers, more
research is needed to better understand how other immunotherapies might
help.

SKIN CANCER:

Early skin cancers often respond well to traditional cancer treatments such as
surgery. But advanced cases may benefit from immunotherapy. The FDA has
approved several checkpoint inhibitors for skin cancers, including melanoma.

STOMACH CANCER:

This is also called a gastric cancer. A checkpoint inhibitor and two targeted
antibodies are approved to treat advanced cases of stomach or
gastroesophageal cancer in certain people.

BENEFITS AND RISKS OF

IMMUNOTHERAPY:-
Overall, immunotherapies are still less common
than surgery or chemotherapy to treat cancer. But for some types of cancer,
these therapies are now an important treatment option. Many other
immunotherapies are still in clinical trials.

Immunotherapies have the potential to be more comprehensive and less toxic

than other types of treatments for cancer, because they harness the power of

16
the body itself to attack the tumor instead of introducing chemicals into the
body.

Immunotherapies are a very active area of research in cancer therapy, and

new treatments continue to be approved.

Risks vary by the type of immunotherapy, the type of cancer, the stage, a
patient’s general health and current treatment regimen. Every treatment has
different side effects, and patients may respond differently to the same
treatment.

Generally, there are side effects when you ramp up the immune system to
function on “high.” Like when you get a vaccine, you may experience flu-like
symptoms—including fever, chills, weakness, dizziness, nausea, muscle aches,
fatigue or headache—because the immune system is doing its job.

These treatments may cause high levels of inflammation in healthy cells and
tissues and side effects from that response, such as a skin rash. Steroids may
treat the side effects from that inflammation—but steroids also have some
side effects of their own.

Some people develop resistance to immunotherapy. Rarely, doctors have

observed severe or even fatal allergic and inflammatory reactions to some
types of immunotherapy.

Your body may or may not respond to immunotherapy. Only some people
receiving these treatments respond to them. Researchers are working on
better understanding the common link between people who do respond and
why.

DIFFERENCE BETWEEN IMMUNOTHERAPY

AND CHEMOTHERAPY :-
Both immunotherapy and chemotherapy are commonly used cancer
treatments that use drugs to stop or slow the growth of cancerous cells.
However, while chemotherapy drugs are used to attack rapidly producing
cells throughout the body, immunotherapy triggers the immune system’s
ability to identify and attack cancer cells.

17
The side effects can be very different between chemotherapy and
immunotherapy, too. Because chemotherapy can’t differentiate between the
cells it’s targeting, it affects both fast-growing cancerous and fast-growing
normal cells, like those responsible for hair and skin growth and those lining
the digestive tract and forming bone marrow. That why side effects like hair
loss, nausea and vomiting, and skin and nail changes are more common and
sometimes more severe with chemotherapy.

TUMOR AGNOSTIC THERAPIES :-

The FDA has also approved immunotherapy to treat cancers with specific
genetic features, regardless of where in the body they originate. These
treatments, called tumor-agnostic therapies, may be used to treat these
malignancies:

Solid tumors with microsatellite instability-high (MSI-h) or mismatch repair

deficiency (dMMR): These tumors may have unstable strands of DNA or are
unable to repair DNA damage.

Solid tumors with high tumor mutation burden (TMB-h): These tumors have
cells with a high number of different gene mutations, which may make them
more likely to respond to immunotherapy.

CANCER TREATMENT VACCINES :-

Cancer treatment vaccines are a type of immunotherapy that treats cancer by
strengthening the body’s natural defenses against the cancer. Unlike cancer
prevention vaccines, cancer treatment vaccines are designed to be used in
people who already have cancer—they work against cancer cells, not against
something that causes cancer.

The idea behind treatment vaccines is that cancer cells contain substances,
called tumor-associated antigens, that are not present in normal cells or, if
present, are at lower levels. Treatment vaccines can help the immune
system learn to recognize and react to these antigens and destroy cancer cells
that contain them.

Cancer treatment vaccines may be made in three main ways.

18
 1. They can be made from your own tumor cells. This means they are
custom-made so that they cause an immune response against
features that are unique to your cancer.
2. They may be made from tumor-associated antigens that are found
on cancer cells of many people with a specific type of cancer. Such a
vaccine can cause an immune response in any patient whose cancer
produces that antigen. This type of vaccine is still experimental.
3. They may be made from your own dendritic cells, which are a type
of immune cell. Dendritic cell vaccines stimulate your immune
system to respond to an antigen on tumor cells. One dendritic cell
vaccine has been approved, sipuleucel-T, which is used to treat
some men with advanced prostate cancer.

A different type of cancer treatment, called oncolytic virus therapy, is

sometimes described as a type of cancer treatment vaccine. It uses
an oncolytic virus, which is a virus that infects and breaks down cancer cells
but does not harm normal cells.

The first FDA-approved oncolytic virus therapy is talimogene laherparepvec

(T-VEC, or Imlygic). It is based on herpes simplex virus type 1. Although this
virus can infect both cancer and normal cells, normal cells are able to kill the
virus while cancer cells cannot.

T-VEC is injected directly into a tumor. As the virus makes more and more
copies of itself, it causes cancer cells to burst and die. The dying cells release
new viruses and other substances that can cause an immune response against
cancer cells throughout the body.

Immunotherapy is an effective treatment option for pediatric patients with

stinging insect hypersensitivity and AR (Box 23-2). It is also effective in
selected patients with asthma. There is a small but definite risk of systemic
allergic reactions; therefore facilities administering immunotherapy should be
adequately prepared to handle such an event and patients should remain in
the medical facility for 30 minutes after receiving the injection (Box 23-3).
Immunotherapy may act to suppress allergic symptoms through modification
of antibody responses, lymphocyte responses or target cell responses to
allergen. Studies are under way to determine whether modifications of
immunotherapy reagents or dosing route will improve its efficacy or reduce
side-effects. Immunotherapy is also being pursued as a treatment option

19
for food allergy, and there is some evidence to suggest that immunotherapy
may alter the natural progression of sensitization.

BIBLIOGRAPHY

cancer.net

verywellhealth.com

mdanderson.org

webmd.com

cancer.org

20