Immune system modulators help regulate and enhance the body’s immune response to combat cancer. These modulators include cytokines, BCG, and immunomodulatory drugs, each playing a crucial role in boosting immune activity or reducing treatment side effects.
Cytokines
Cytokines are proteins produced by white blood cells that support normal immune functions and enhance the immune system’s ability to fight cancer. Key cytokines used in cancer treatment include:
- Interferons (INFs): INF-alpha activates white blood cells, such as natural killer cells and dendritic cells, to strengthen the immune response against cancer. It may also slow cancer cell growth or trigger their destruction.
- Interleukins (ILs): Among the many interleukins, IL-2, also known as T-cell growth factor, increases the number of white blood cells like killer T cells and natural killer cells. This boost enhances the immune system’s ability to target cancer cells. IL-2 also helps B cells produce substances that can further attack cancer cells.
Some cytokines, known as hematopoietic growth factors, are used to counteract the effects of chemotherapy by stimulating blood cell production:
- Erythropoietin: Encourages the production of red blood cells.
- IL-11: Increases platelet production.
- Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) & Granulocyte Colony-Stimulating Factor (G-CSF): Raise white blood cell levels, reducing infection risks and strengthening the immune response against cancer.
BCG (Bacillus Calmette-Guérin)
BCG is a weakened form of tuberculosis-causing bacteria that does not cause disease in humans. It is used primarily to treat bladder cancer. When administered directly into the bladder via a catheter, BCG triggers an immune response against cancer cells. Researchers are also investigating its potential use in other cancers.
Immunomodulatory Drugs
Also called biological response modifiers, these drugs stimulate the immune system and interfere with tumor growth. They include:
- Thalidomide (Thalomid®)
- Lenalidomide (Revlimid®)
- Pomalidomide (Pomalyst®)
- Imiquimod (Aldara®, Zyclara®)
Thalidomide, lenalidomide, and pomalidomide enhance IL-2 release, boosting immune activity. Additionally, they prevent tumors from forming new blood vessels, a process known as angiogenesis inhibition, which is crucial for tumor growth.
By leveraging these immune system modulators, researchers and doctors continue to refine cancer treatments, improving patient outcomes and enhancing the body’s natural ability to fight cancer.
Cancers Treated with Immune System Modulators
Most immune-modulating agents are used to treat advanced cancers, while some help manage treatment-related side effects. These therapies work by boosting the immune system’s ability to detect and attack cancer cells.
Side Effects of Immune System Modulators
Immune-modulating agents can cause side effects, which vary from person to person. Factors such as overall health before treatment, cancer type, disease stage, the specific agent used, and dosage influence how a patient experiences these effects.
Doctors cannot predict exactly when or how severe side effects will be, so it’s crucial to recognize potential symptoms and seek medical attention if issues arise.
Common Side Effects
Many immune-modulating agents cause flu-like symptoms, including:
- Fever
- Chills
- Weakness
- Dizziness
- Nausea or vomiting
- Muscle or joint aches
- Fatigue
- Headache
Serious Side Effects of Cytokines
Cytokine-based therapies can lead to more severe reactions, such as:
- Breathing difficulties
- High or low blood pressure
- Severe allergic reactions
- Reduced blood cell counts, increasing the risk of infections and bleeding issues
- Blood clots
- Mood, behavioural, cognitive, and memory problems
- Skin reactions, including rashes, injection site irritation, and ulcers
- Potential organ damage
BCG Side Effects
BCG therapy, commonly used for bladder cancer, may cause urinary side effects.
Side Effects of Immunomodulatory Drugs
Thalidomide, lenalidomide, and pomalidomide can result in:
- Blood clots
- Nerve damage, causing pain, numbness, tingling, swelling, or muscle weakness
- Birth defects if taken during pregnancy
Side Effects of Imiquimod
Imiquimod, a topical immune modulator, may cause skin reactions.
Monitoring side effects and communicating with healthcare providers can help manage symptoms and improve treatment outcomes.
Resource:
Immune System Modulators was originally published by the National Cancer Institute.
Sarcomafree Foundation is a non-profit organization dedicated to providing comprehensive information about sarcoma and innovations in cancer treatment. We welcome your suggestions for topics or feedback, so please don’t hesitate to reach out and share your thoughts with us!
