Cancer Immunotherapy, A Simple Guide To Different Types, And Its Uses In Cancer Treatment

By Kenneth Kee

Immunotherapy has now emerged as the fourth pillar of cancer treatment standing together with surgery, radiotherapy and chemotherapy.
Immunotherapy is treatment that makes use of a person’s immune system to fight diseases such as cancer.
This can be done in a couple of ways:
1. Stimulating the own immune system to work harder or smarter to attack cancer cells
2. Giving the patient immune system components, such as man-made immune system proteins
Some types of immunotherapy are also called:
1. Biologic therapy - treatment using the biological use of living organisms e.g. cancer vaccine
2. Targeted therapy - targeted at the specific cancer cells
Other new Cancer therapies are:
Cancer vaccines
Oncolytic Viruses
BCG Therapy
Adoptive T-cell Transfer Therapy
The purposes of cancer immunotherapy are to kill or control cancer cells by activating, or reactivating the immune system.
1.Controlling the immune system: immune checkpoints
The activity of the immune system is changed and carefully controlled by costimulatory molecules called immune checkpoints.
Immune checkpoints of relevance to cancer are CTLA4, PD1 and PDL1.
If the signals are largely positive, the immune cell is triggered and is ready to attack the antigen presented by the target cell.
2.Cancer immunosurveillance and immunoevasion
The moment tiny cancers form, the abnormal proteins they express from mutated genes produce so-called neoantigens that can be identified by the immune system by antigen presentation, targeting the mutated cell for destruction.
Cancers are corrected by this process, and may be eradicated at this point; known as immunosurveillance.
Cancer immunotherapies attempt to rectify these escape mechanisms at many points, but a key mechanism for cancer cells to evade the immune system seems to be by negative immune checkpoint signaling
Doctors have find ways to help the immune system identify cancer cells and strengthen its response so that it will destroy them.
The main forms of immunotherapy now being used to treat cancer are:
1. Monoclonal antibodies:
Monoclonal antibodies work by binding to cancer cells, allowing the immune system to find, attack, and kill the cells
Other monoclonal antibodies work by obstructing signals on the surface of the cancer cell that tell it to divide.
Another type of monoclonal antibody carries radiation or a chemotherapy drug to cancer cells.
Non-Hodgkin lymphoma
Hodgkin lymphoma
Chronic lymphocytic leukemia
Anaplastic large cell lymphoma
Advanced melanoma
Stomach cancer
Breast cancer
Advanced colon or rectal cancer
Kidney cancer
Cancers of the head and neck
2. Immune checkpoint inhibitors:
Immune checkpoint inhibitors are a newer form of monoclonal antibody that works on these checkpoints to boost the immune system so it can attack cancer cells.
Melanoma of the skin
Non-small cell lung cancer
Kidney cancer
Hodgkin lymphoma
3. Cancer vaccines:
Vaccines are materials put into the body to induce an immune response against certain diseases.
But some vaccines such as HPV can assist in preventing or treating cancer.
3. Other, non-specific immunotherapies:
These treatments improve the immune system in a general way, but this can still assist the immune system attack cancer cells.
Interleukin-2 (IL-2) helps immune cells grow and divide more quickly
Interferon alpha (INF-alfa) induces certain immune cells more capable to attack cancer cells

Immunotherapy is less toxic than chemotherapy and radiation because the body cells are used to fight cancer and not toxins.
It is therefore safer.

TABLE OF CONTENT
Introduction
Chapter 1 Immunotherapy
Chapter 2 Immune System and Cancer
Chapter 3 Types of Immunotherapy
Chapter 4 Destruction of Cancer Cells by Immunotherapy
Chapter 5 Recent Cancer Immune Treatme

• Language: English
• Publisher: Kenneth Kee
• Release date: Oct 17, 2017
• ISBN: 9781370669202

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Cancer Immunotherapy,

A

Simple

Guide

To

Different Types,

And Its Uses

In Cancer

Treatment

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2017 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Cancer Immunotherapy and its uses in Cancer Treatment which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Cancer with Immunotherapy)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Immunotherapy

What is cancer immunotherapy?

Immunotherapy is treatment that makes use of certain elements of a person’s immune system to fight diseases such as cancer.

This can be done in a couple of ways:

1. Stimulating the immune system to work harder or smarter to attack cancer cells

2. Giving the patient immune system components, such as man-made immune system proteins

Some types of immunotherapy are also sometimes called:

1. Biologic therapy - treatment using the biological use of living organisms e.g. cancer vaccine

2. Targeted therapy - targeted at the specific cancer cells

The purposes of cancer immunotherapy are to kill or control cancer cells by activating, or reactivating the immune system.

In the last few decades immunotherapy has become an important part of treating some forms of cancer.

Immunotherapy has now emerged as the fourth pillar of cancer treatment standing together with surgery, radiotherapy and chemotherapy.

Newer forms of immune treatments are now being studied

They will affect how the doctors treat cancer in the future.

Immunotherapy involves treatments that work in different ways.

Some boost the body’s immune system in a very general way.

Others help train the immune system to attack cancer cells specifically.

Immunotherapy acts better on the treatment of some types of cancer than for others.

It is used by itself for some of these cancers, but for others it seems to work better when used with other types of treatment.

What the immune system does

The immune system is a collection of organs, special cells, and substances that help protect the patient from infections and some other diseases.

1. The innate immune response is activated by chemical properties of the antigen.

Innate immunity starts with physical barriers (skin, mucus), and involves non-specific defenses from immune cells such as neutrophils and natural killer cells.

2. Adaptive immunity refers to antigen-specific immune response.

The adaptive immune system has developed from innate immune cells, which are B-cells that produce antibodies

It is governed by lymphocytes, primarily alpha/beta, which includes CD4+ helper, CD8+ killer and FOXP3+ regulatory T-cells.

The adaptive immune system is most significant in:

1. Organizing the immune system,

2. Treating viral infections

It has developed to be the most important part of the immune system in terms of regulating and removing cancer.

Adaptive immune cells identify other cells by antigen presentation.

A small peptide fragment of a native, viral or cancer protein (the antigen or epitope) is placed on a cell surface complex made of proteins called the major histocompatibility complex (MHC).

These epitopes are then identified by proteins (e.g. the T-cell receptor, TCR) on the surface of individual T- or B-cell lymphocytes (Figure A).

The gamut of human T-cells and B-cells can identify up to 109 individual patterns.

The outlook of antigen presentation and recognition is decided by the balance of interactions between pairs of immune checkpoint costimulatory molecules (e.g. CTLA4-CD80, OX40-OX30L, CD154-CD40, PD1-PDL1).

Immune cells and the substances they make travel through the body to protect it from germs that cause infections.

They also help protect the patient from cancer in some ways.

Controlling the immune system: immune checkpoints

Poorly regulated immune activation results in autoimmune diseases like ulcerative colitis, dermatitis and interstitial pneumonitis.

The activity of the immune system is changed and carefully controlled by costimulatory molecules called immune checkpoints.

When antigen recognition happens, a group of other molecules interacts on the surface of the immune cell and the target cell to find out the balance of the interaction.

If the signals are largely positive, the immune cell is triggered and is ready