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BackgroundOver the past few years, cancer treatments have made a lot of progression.Traditionally, cancer patients are treated with chemotherapy, radiation therapy.They can be extremely toxic and have many severe side effects, as they are systemic treatments, meaning that they can affect cells all over the body, including healthy cells.Because of these reasons, researchers are looking for more effective treatments with fewer side effects.One of the up-and-coming treatments in the cancer field is called cancer immunotherapy. It is a line of treatment that takes advantage of the immune system and causes immune cells to shrink tumorsIntroductionThe immune system is the human body’s defense mechanism against foreign substances or things that may cause disease. It’s mostly made up of the skin, the lining of the gut and lungs, the lymph nodes, and white blood cells (B and T cells), as well as other parts of the bodyB cells are like security cameras, Once they have found a pathogen, they interact with T cells to “inform” them of the invader. The T cells,are like guards,they go to the pathogen and kill it.Cancer cells form from normal cells which are mutated. They can exponentially grow without any restraint. These cancer cells are not recognized and destroyed by the immune system because they are often mutated in a particular form so, that they cannot be killed by the immune system.Cancer cells evolve constantly to not be detected by the immune system. This can happen in multiple ways such as…1) Reducing the count of particular proteins that are found on the cell surface to prevent being seen by the immune system AKA- ( B cells)2) Increasing the count of proteins on the cell surface to stop the immune system from attacking them -( T cells)After understanding the tactics cancer cells use to slide by being destroyed by immune cells, researchers have come up with multiple forms of immunotherapy which can help treat cancer and currently it is the best way to treat some cancers in particular, especially skin cancers.Types of Cancer Immunotherapy1)Immune Checkpoint Inhibitors2) Monoclonal antibodies3) Cancer vaccines4)Non-specific immunotherapyImmune Checkpoint InhibitorsExamples are CTLA4 Inhibitors,PD 1 Antibodies, and modified T cells.CTLA4 cytotoxic T-lymphocyte-associated protein 4 Antibody White blood cells have proteins on the surface of the cells that stop immune cells from attacking healthy cells. One of these proteins is called CTLA4 (cytotoxic T–lymphocyte-associated protein 4). This protein communicates to a similar protein that is on cancer cells, and do not let T cells work against cancer cells. This makes cancer cells immortal as they are prevented from being detected by the immune system.Antibodies against CTLA4 can be used to prevent CTLA4 from being turned on, allowing the immune cells to do their jobs.The FDA approval was given in 2011 for treatment of skin cancer.Ipilimumab(Yervoy) is used to treat melanoma of the skin. It is also being studied for possible usage against other cancers as well. Another one is PD-1 inhibitors.There are 2 proteins expressed by cancer cells that can bind to and activate PD-1, causing the T cells to be inhibited and allowing the cancer cells to survive. researchers developed antibodies against PD-1. Two PD-1 antibodies have been very successful and have been FDA approved for various cancers. Examples of PD-1 inhibitors are Pembrolizumab(Keytruda) and Nivolumab(Opdivo). These drugs are used in many cancers like melanoma of the skin,non-small cell lung cancer,kidney cancer, and bladder cancer.Examples of PD-L1 inhibitors are Atezolizumab(Tecentriq), Avelumab(Bavencio), and Durvalumab(Imfinzi). They are used for bladder cancer,non-small cell lung cancer, Merkel skin cancer. They are also being examined to see if they can be used to cure any other cancer or help the patient in any way.Modified T-cellsT cells are taken from a patient, then genetically modified to have proteinsT on their surface that recognize a specific protein found only on cancer cells. These modified cells can be grown and multiplied in the laboratory and then put back into the patient. Once in the patient, the modified T cells can multiply, recognize, and kill cancer cells. The problem with this therapy is trying to figure out a specific protein on cancer cells to target, since many of the proteins that are found on cancer cells are also found on healthy cells. The T cells would bind to anything with the specific protein on it, regardless of whether a cell is healthy or diseased, since it is unable to tell the difference between the two. However, if a protein can be found that is only expressed on cancer cells and not normal cells, this therapy can be used. For example, this therapy has been used in advanced cases of blood cancer. An example is car T-cell therapy.AdvantagesImmunotherapy slows the growth of cancer cells by a lot sometimes, it can even stop the growth of cancer cells for a long period of time as well. It also morevor stops cancer from spreading to other parts of the body. Immunotherapy is basically just a booster to your original to immune system which helps them destroy cancer cells. The side effects of immunotherapy are generally milder than those of chemotherapy or radiation therapy, since immunotherapy is more specific and more targeted towards cancer cells than the other therapies.DisadvantagesAs with many cancer treatments, costs can be quite high, and cancer immunotherapy is no exception. Some cancer immunotherapies can cost as much as $100,000 per year. Cancer immunotherapy also has side effects, but the benefits of the treatment far outweigh the costs.However, as with most cancer treatments, cancer immunotherapy only works for a certain period of time. Eventually the cancer returns and grows again, meaning that immunotherapy is not a miracle cure for cancer. However, it is another weapon in our arsenal against cancer and can extend a patient’s life for a significant amount of time. ReflectionImmunotherapy is a cancer treatment that boosts a person’s immune system.  It can be done in a few ways and they are done in different techniques. It kind of puts the immune system on high alert for example when a lion get loose from a zoo the zoo members are on high alert and have to beware of the lion. It is very different in our case as a human our body’s own cells mess up some type of encoding in the protein which causes everything to go haywire. Another problem is that once one cancer cell is produced more cancer cells start being produced. Different types of cancers have different type of reproduction rates. Pancreas cancer is one of the fastest cancers so the cancer cells in Pancreas cancer reproduce much quickly. It also needs to be understood that the Pancreas is a vital part of the body that produces insulin. The second way is giving yourself man made immune system proteins that strengthen your immune system. Immunotherapy at times may be called Biological Therapy as well as Bio Therapy. Immunotherapy works in many different ways it can boost your immune system for cancer cells or train themselves for cancer cells. Immunotherapy is proven to work on some cancers more effectively than others and a few examples of those are Bladder and Brain cancer. It also tends to work much more efficiently with other treatments as well. TreatmentsHere are some types of cancer immunotherapy. Monoclonal antibodies are man made styles of immune system proteins. They can be made to attack a very specific type or part of cancer cell.Immune Checkpoint Inhibitors are things that get rid of the thing holding the immune system back which allows it to recognize cancer cells and attack them. Cancer Vaccines are vaccines that help develop an immune response against cancer cells. Nonspecific immunotherapies can help the immune system attack cancer cells.ConclusionLooking at research given so far, cancer immunotherapy is showing great promise and has already been FDA-approved for various cancers. Immunotherapy for many other cancers is currently being studied, and while there are obstacles to be overcome, cancer immunotherapy looks to be a huge step in the war against cancer. Some say it’s the best thing since sliced bread, and they might be right, or they might be wrong. Only time will tell what will happen to cancer and its cures. CitationsIvashko, I. N. and J. M. Kolesar (2016). “Pembrolizumab and nivolumab: PD-1 inhibitors for advanced melanoma.” Am J Health Syst Pharm 73(4): 193-201.Klebanoff, C. A., S. A. Rosenberg, et al. (2016). “Prospects for gene-engineered T cell immunotherapy for solid cancers.” Nat Med 22(1): 26-36.Mahoney, K. M., P. D. Rennert, et al. (2015). “Combination cancer immunotherapy and new immunomodulatory targets.” Nat Rev Drug Discov 14(8): 561-584.Mellman, I., G. Coukos, et al. (2011). “Cancer immunotherapy comes of age.” Nature 480(7378): 480-489.Pardoll, D. M. (2012). “The blockade of immune checkpoints in cancer immunotherapy.” Nat Rev Cancer 12(4): 252-264.Pico de Coana, Y., A. Choudhury, et al. (2015). “Checkpoint blockade for cancer therapy: revitalizing a suppressed immune system.” Trends Mol Med 21(8): 482-491.Preusser, M., M. Lim, et al. (2015). “Prospects of immune checkpoint modulators in the treatment of glioblastoma.” Nat Rev Neurol 11(9): 504-514.Restifo, N. P., M. E. Dudley, et al. (2012). “Adoptive immunotherapy for cancer: harnessing the T cell response.” Nat Rev Immunol 12(4): 269-281.Sharma, P. and J. P. Allison (2015). “Immune checkpoint targeting in cancer therapy: toward combination strategies with curative potential.” Cell 161(2): 205-214.Spain, L. and J. Larkin (2016). “Combination immune checkpoint blockade with ipilimumab and nivolumab in the management of advanced melanoma.” Expert Opin Biol Ther: 1-8.Srivastava, S. and S. R. Riddell (2015). “Engineering CAR-T cells: Design concepts.” Trends Immunol 36(8): 494-502.Topalian, S. L., C. G. Drake, et al. (2015). “Immune checkpoint blockade: a common denominator approach to cancer therapy.” Cancer Cell 27(4): 450-461.Ulmeanu, R., I. Antohe, et al. (2016). “Nivolumab for advanced non-small cell lung cancer: an evaluation of a phase III study.” Expert Rev Anticancer Ther 16(2): 165-167.van der Stegen, S. J., M. Hamieh, et al. (2015). “The pharmacology of second-generation chimeric antigen receptors.” Nat Rev Drug Discov 14(7): 499-509.Weiner, L. M., R. Surana, et al. (2010). “Monoclonal antibodies: versatile platforms for cancer immunotherapy.” Nat Rev Immunol 10(5): 317-327.09.14.2016 –

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