Immunotherapy in gastrointestinal oncology: A new dawn for cancer treatment

Gastrointestinal (GI) cancers, including cancers of the colon, stomach, esophagus, pancreas, and liver, affect millions of people worldwide and remain a leading cause of mortality. While surgery remains the gold standard treatment for curing GI cancers, chemotherapy and radiation therapy help in downstaging the disease and reduce the risk of recurrence. Over the last decade, new wave of treatments known as immunotherapy is revolutionizing the landscape of GI oncology, offering improved outcomes and increased hope for patients in downstaging the disease and aiding more patients to become operable.

Immunotherapy, a form of cancer treatment that harnesses the body's own immune system to target and eliminate cancer cells, has emerged as a beacon of hope for many cancer patients. Traditionally, gastrointestinal cancers presented formidable challenges due to their aggressive nature and limited response to conventional treatments. However, immunotherapy has ushered in a new era by unlocking the potential of the immune system to recognize and attack cancer cells with precision. While it has made substantial strides in various cancer types, its impact on gastrointestinal oncology is particularly noteworthy.

How does immunotherapy work?

Unlike traditional treatments that directly target cancer cells, immunotherapy harnesses the power of the body's own immune system to fight cancer. It does this by removing the "brakes" that cancer cells use to evade immune attack, allowing immune cells to recognize and destroy cancer cells effectively.

Types of immunotherapy in GI oncology:

• Immune checkpoint inhibitors: These antibodies target specific proteins on immune cells, such as PD-1 and CTLA-4, allowing them to become more active against cancer cells. These are the most well-established immunotherapies, approved for various GI cancers including colorectal, gastric, and esophageal cancers.

• T-cell therapies: These involve extracting T cells, a type of immune cell, from the patient, genetically modifying them to recognize and attack cancer cells, and then reinfusing them back into the patient. CAR T-cell therapy has shown promising results in certain GI cancers, particularly those with specific genetic mutations.

• Oncolytic viruses: These genetically engineered viruses selectively infect and destroy cancer cells while leaving healthy cells unharmed. They can also stimulate the immune system to attack tumors.

• Cancer vaccines: These vaccines teach the immune system to recognize and attack specific cancer antigens. While still under development, cancer vaccines hold promise for preventing GI cancers and treating early-stage disease.

Benefits of immunotherapy:

• Improved efficacy: Immunotherapy has shown significant efficacy in treating advanced GI cancers, often leading to longer-term survival and improved response rates compared to traditional therapies.

• Reduced side effects: Compared to chemotherapy and radiation, immunotherapy typically has fewer and milder side effects, improving patients' quality of life during treatment.

• Durable responses: Immunotherapy can induce long-lasting immune responses against cancer cells, potentially leading to remission and even cure in some cases.


As we look ahead, immunotherapy stands as a beacon of hope in the world of stomach and gut cancers. It's not just about fighting the enemy but changing the entire game. With ongoing research and a commitment to making immunotherapy even better, we're on a journey towards a future where these cancers are treatable even in advanced cases. So, let's cheer on our new superhero, immunotherapy, in the ongoing battle against these tough foes.

(Author: Dr. Prabhu Nesargikar, Senior Consultant, GI Robotic Surgeon, HCG Cancer Centre Hospital, KR Road, Bengaluru)