Rising cancer cases in India: The role of Immunotherapy in treatment

The burden of non-communicable diseases (NCDs) is rising rapidly in India, with Cancer cases exceeding global cases at an alarming pace. In 2022, over 14.1 lakh new cancer cases were diagnosed and about 9.1 lakh fatalities were recorded. The number of cancer cases are now surpassing the global average and if this continues very soon, India could be labelled as the ‘Cancer Capital of the World’. To improve cancer treatment, the medical community has been continually making improvements in the treatment of cancer over the years, leading in better results and newer treatment options. While traditional methods such as chemotherapy, surgery and radiotherapy, are the most trusted forms of treatment for doctors. Immunotherapy, an advanced cancer treatment backed by science, has proven to be revolutionary for cancer patients in India. Having been in practice for the past decade, it has emerged as a game changer in cancer treatment, offering new hope and transforming outcomes for many patients.

Immunotherapy, also referred to as immuno-oncology, leverages the body’s immune system to combat, control and prevent cancer. The immune system serves as a natural defence mechanism protecting against infections, cancer and other NCD’s. When harmful pathogen’s such as bacteria or viruses invade the human body, the immune system response helps to prevent them from causing any harm. In cancer, Immunotherapy stimulates the immune system as the body’s natural defence mechanism, to identify and attack the cancer cells as it would with other harmful pathogens. Therefore, by efficiently targeting the malignant cells it offers the potential to be effective against many forms of cancers.

Immunotherapy is suitable for different forms of cancer as a first- or second-line of treatment. It has the capacity to address various types of cancer, right from the preventive vaccine for cervical cancer to first line therapy for metastatic cancer. In certain cases, doctors may combine immunotherapy with traditional treatments like chemotherapy or radiotherapy for better outcomes. However, deciding whether immunotherapy is the appropriate form of treatment of cancer depends on several critical factors including type and stage of cancer, as well as patient’s overall health and its response to the treatment.

Types of Immunotherapies Available in IndiaCancer treatment using immunotherapy involves a multidisciplinary approach governed by different principles resulting in positive patient outcomes.
Checkpoint Inhibitors: These drugs allow the immune system to better detect and kill tumours by removing the “brakes” that inhibit its activity.
Cytokines: These small proteins enlist immune cells to fight cancer.
Immunomodulators: These agents increase certain parts of the immune system activity that are directed against cancers.
Monoclonal Antibodies: These are synthetic immune molecules that are very specific to portions of malignancy and act to recruit the immune systems to destroy them.
Chimeric Antigen Receptor (CAR) T-cell Therapy: This is an advanced blood cancer therapy that involves taking blood from a patient to obtain white blood cells, called T-cells, and genetically engineering them to attack the malignant cells. Once modified, the T-cells are returned to the patient with the intent of seeking and eliminating the malignant cells.

Both chemotherapy and immunotherapy are effective cancer treatment options, though they are governed by different principles. Chemotherapy is more of a direct form of treatment that kills the tumour cells, but it can also in the process harm the healthy cells that may result in side effects. Immunotherapy, on the other hand, works by helping the body’s immune system identify, target, and specifically eliminate the cancer cells. Immunotherapy is indicated for the following cancers, though some forms differ in the manner of administration. The most common of these is intravenous (IV) where the medication is directly administered into the vein. The other method is Intravesical, in which immunotherapy is administered straight into the bladder. By leveraging the body’s own immune system to fight cancer, immunotherapy offers a targeted approach that can lead to improved outcomes and a better quality of life for patients. Immunotherapy can result in side effects that vary from those associated with conventional cancer therapies. Common side effects include, but are not limited to, skin reactions, mouth sores, fatigue, nausea, body aches, headaches, and blood pressure changes.

(Author: Dr Ankur Varshney, Medanta Hospital, Delhi)