Immunotherapy
What is immunotherapy?
The immune system protects the body against illness and infection. Cancer immunotherapies are treatments that use the immune system to find and attack cancer cells.
There are different types of immunotherapy, including:
- monoclonal antibodies
- checkpoint inhibitors
- immune system modulators
- cancer vaccines
- CAR-T therapy
- virus therapy.
Each type of immunotherapy uses the immune system in a different way. Some are given in combination with other cancer drugs, such as chemotherapy. This is called chemoimmunotherapy.
This page has general information about cancer immunotherapy. You can search for information about a specific immunotherapy drug or combination of drugs using our cancer treatments and drugs A to Z.
You can also learn more in our cancer drug treatments information. This includes how treatment is planned, and what to expect before and during a cancer drug treatment.
Your course of immunotherapy treatment
Your cancer team will talk to you about the treatment you need and the possible side effects before you agree (consent) to have treatment.
How often you have immunotherapy, how it is given and how long your course of treatment lasts depends on:
- the type of cancer
- the type of immunotherapy you are having
- how the cancer responds to the treatment
- any side effects you have.
Treatment cycles
Cancer drugs are often given as several sessions of treatment, with a rest period in between each session. The rest period allows your body to recover from the side effects. Many immunotherapies are given in this way.
The treatment session and the rest period make up 1 cycle of your treatment. Your cancer team can explain the number of cycles you may need.
How is immunotherapy given?
Many immunotherapy drugs are given as:
- a drip into a vein (intravenous)
- an injection under the skin (subcutaneous).
But others may be given in the following ways:
- Lenalidomide, pomalidomide and thalidomide are taken as tablets.
- BCG is given directly into the bladder.
- T-VEC is given as an injection into an area of melanoma.
Immunotherapy given into a vein or as an injection
If you are having an immunotherapy drug given into a vein or under the skin, you usually have this at a day unit or clinic as an outpatient.
You may have immunotherapy into a vein through:
- a cannula – a short, thin tube the nurse puts into a vein in your arm or hand
- a central line – a fine tube that goes under the skin of your chest and into a vein close by
- a PICC line – a fine tube that is put into a vein in your arm and goes up into a vein in your chest
- an implantable port (portacath) – a disc that is put under the skin on your chest or arm and goes into a vein in your chest.
The nurse will explain how long your immunotherapy treatment will take. For drugs into a vein, they usually use a pump to give you a controlled amount of treatment over a fixed time. This can be from 10 minutes to several hours, depending on the drug.
Related pages
Side effects of immunotherapy
Different types of immunotherapy can cause different side effects. Your cancer team will give you information about possible side effects before you start treatment. You may get some of the side effects they mention, but you are unlikely to get all of them.
Your cancer team can give you:
- drugs to help control some side effects
- advice about managing your side effects.
It is important to take any drugs exactly as explained. This means they will be more likely to work for you.
Contacting the hospital
Your cancer team will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
Sometimes side effects can become serious very quickly. Always contact the hospital straight away for advice.
Your patient alert card
More information about side effects
If you need information about a specific immunotherapy, you can check our cancer treatments and drugs A to Z. We have detailed information about many types of cancer drugs and their possible side effects.
You can also talk to your cancer team if you want more detailed information about a treatment. Or visit the electronic medicines compendium (emc) website, which has patient information leaflets (PILs) for individual drugs.
Other useful resources
If you want to explore more information about checkpoint inhibitor treatment and side effects, these resources may help:
- visit our cancer treatment forum – our Online Community is a place to talk with others having treatment, share your experience, and ask a cancer expert your questions.
- listen to The Immunobuddies podcast - founded and co-hosted by Medical Oncologist, Dr Ricky Frazer, episodes 56 to 61 answers questions on immunotherapy from a patient perspective.
Immune system side effects
Immunotherapy makes the immune system more active. That means it is better at finding and attacking cancer cells. For checkpoint inhibitor immunotherapy drugs, this can also cause unwanted effects. These are called immune system side effects or immune-related side effects.
Immune system side effects are different from the side effects of other cancer treatments, such as chemotherapy or radiotherapy. They are caused by the immune system attacking normal cells in the body as well as the cancer cells.
Immune system side effects may:
- be mild to start with
- quickly become serious unless treated
- start during treatment
- start weeks, months or sometimes more than a year after you finish treatment.
Some immune system side effects are rare. But it is important to know about them and to get advice if you have any side effects during treatment or after treatment ends.
If you have any of the following symptoms or side effects, contact the hospital straight away on the 24-hour number. Do not try to treat this type of side effect yourself.
Immune system side effects can affect any part of the body. We have shared examples for the following side effects. But your cancer team will explain your treatment and any important side effects that you should know about.
-
Skin, rashes and itching
-
Bowels, tummy and diarrhoea
-
Lungs and breathing
-
Liver
-
Kidneys and passing urine
-
Hormones and feeling tired
-
Heart and chest
-
Muscles and joints
-
Head, brain and nerves
Long-term and late effects of immunotherapy
Cancer treatments sometimes cause side effects that do not go away after cancer treatment. Or they may cause side effects that start months or years after treatment ends. These are called long-term or late effects.
Many immunotherapies are newer treatments, and their possible long-term effects are still being researched. The benefit of having the treatment usually outweighs the risk of developing serious long-term effects.
Your cancer doctor, nurse or pharmacist can explain what is known about your treatment. Always get advice from your cancer team about any new symptoms or side effects.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
-
References
Rajinder Nijjar
Reviewer
Lead Cancer Pharmacist
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.