Classes of Immunotherapy
Immune Checkpoint Inhibitors
Antibodies such as pembrolizumab, nivolumab, atezolizumab and ipilimumab block checkpoint proteins that tumors use to hide from T cells. Approved across melanoma, lung, kidney, bladder, head & neck, TNBC and many more.
CAR-T Cell Therapy
A patient's T cells are engineered to carry a chimeric antigen receptor targeting CD19 or BCMA, then re-infused. Transformative in relapsed lymphoma, B-cell ALL and multiple myeloma.
Cancer Vaccines
Preventive vaccines (HPV, hepatitis B) stop cancer-causing infections. Therapeutic and personalized mRNA neoantigen vaccines are in advanced clinical trials.
Monoclonal Antibodies & Bispecifics
Antibodies that flag cancer cells for immune attack, and bispecific T-cell engagers (e.g., blinatumomab, teclistamab) that physically link T cells to tumor cells.
Key Biomarkers
Biomarker testing helps predict who is most likely to benefit from immunotherapy.
| Biomarker | What it measures | Why it matters |
|---|---|---|
| PD-L1 expression | Percentage of tumor/immune cells expressing PD-L1 (TPS or CPS score). | Higher expression generally predicts better response to PD-1/PD-L1 inhibitors in lung, gastric, cervical and other cancers. |
| MSI-H / dMMR | Defects in DNA mismatch repair causing microsatellite instability. | Tumor-agnostic approval for pembrolizumab; very high response rates, especially in colorectal cancer. |
| Tumor Mutational Burden (TMB) | Number of mutations per megabase of DNA. | TMB-high (≥10 mut/Mb) tumors create more neoantigens and may respond to checkpoint blockade. |
Adverse Event Management
Because immunotherapy activates the immune system, it can inflame healthy organs — immune-related adverse events (irAEs). Most are mild and reversible when caught early; report new symptoms promptly.
- Pneumonitis — new cough or shortness of breath
- Colitis — diarrhea, abdominal pain or blood in stool
- Endocrinopathies — thyroid, adrenal or pituitary dysfunction causing fatigue, weight change, headache
- Hepatitis — abnormal liver tests, jaundice
- Dermatitis — rash and itching (the most common irAE)
- Treatment typically involves pausing therapy and corticosteroids; hormone replacement may be lifelong for endocrine irAEs.
Frequently Asked Questions
Does immunotherapy work for every cancer?
No. Response rates vary widely — high in melanoma, MSI-H tumors and Hodgkin lymphoma, lower in many others. Biomarker testing and your oncologist's assessment determine whether it is appropriate.
How is immunotherapy given?
Checkpoint inhibitors are IV infusions every 2–6 weeks, sometimes now as subcutaneous injections. CAR-T is a one-time infusion after cell collection and manufacturing, usually at a specialized center.
How long does it take to work?
Responses can take 2–3 months to appear, and tumors occasionally look larger on early scans before shrinking (pseudoprogression).
What is cytokine release syndrome?
A CAR-T and bispecific side effect causing fever, low blood pressure and breathing problems as immune cells activate. It is monitored closely and treated with tocilizumab and steroids.
Medically reviewed content for education only — not a substitute for advice from your oncology team.