Cancer Immunotherapy

Introduction

Cancer immunotherapy is a group of treatments that work with the body’s own immune system to fight cancer. Unlike chemotherapy, which directly attacks cancer cells, immunotherapy helps the immune system recognise cancer cells as a threat and respond to them. Over the past fifteen years, immunotherapy has changed the outlook for several cancers that were once very difficult to treat, including advanced melanoma, certain lung cancers, kidney cancer, bladder cancer, and some blood cancers.

If you or someone in your family has been advised to consider immunotherapy, this article explains what the treatment is, how it works, the main types in use today, what to expect during treatment, the side effects that can occur, and how progress is monitored. It is written for a reader who already has a cancer diagnosis and is now planning or beginning this phase of treatment.

Immunotherapy is a fast-moving area of cancer care. Your oncologist will base the specific plan on the type and stage of your cancer, results of tumour testing, your overall health, and what other treatments you have had. This article gives the general landscape; the individual decisions belong to the conversation with your treating team.

What Is Cancer Immunotherapy?

The immune system is the body’s defence network. It includes white blood cells, antibodies, lymph nodes, the spleen, and many signalling proteins. Its job is to identify and destroy anything that does not belong — bacteria, viruses, and abnormal cells, including some cancer cells.

Cancer cells, however, often find ways to hide from the immune system or to switch off the immune response against them. Some cancers display few markers that the immune system recognises as abnormal. Others actively send signals that tell immune cells to stand down. Immunotherapy is designed to overcome these tricks — either by making cancer cells more visible, by removing the brakes that cancer puts on immune cells, or by giving the body a custom-built immune weapon to use against the tumour.

Immunotherapy is sometimes called biological therapy or biotherapy. The term covers several very different treatments. They share the goal of using or modifying the immune system, but they work in distinct ways and are given in different settings.

Cancer immunotherapy is one of several broad treatment modalities in cancer care, alongside surgery, radiation therapy, chemotherapy, hormonal therapy, and targeted therapy. It can be used on its own or, more often, in combination with these other treatments.

How Cancer Immunotherapy Works

To understand immunotherapy, it helps to know a little more about how the immune system normally responds to cancer.

T cells are a type of white blood cell that can recognise and kill abnormal cells. For a T cell to attack a cancer cell, three things generally need to happen. First, the cancer cell must display a marker that the T cell recognises as foreign or abnormal — these markers are called antigens. Second, the T cell must be activated, which usually happens in the lymph nodes after it sees the antigen presented by another type of immune cell. Third, the T cell must travel to the tumour and not be blocked by signals that tell it to stop attacking.

Cancer can interfere at any of these steps. Some tumours have few antigens. Others express proteins on their surface that bind to “checkpoint” receptors on T cells — like PD-1 or CTLA-4 — effectively pressing a brake pedal that switches off the T cell. Some tumours create a local environment that suppresses immune cells altogether.

A T cell and a cancer cell with PD-1 and PD-L1 checkpoint proteins shown at their shared surface.

AI-generated illustration

Immunotherapy works by intervening in one or more of these steps:

• Releasing the brakes. Checkpoint inhibitors block the proteins that cancer cells use to switch off T cells, allowing the immune response to continue.
• Engineering a better weapon. CAR T-cell therapy takes a patient’s own T cells, modifies them in a laboratory to recognise a specific cancer marker, and infuses them back.
• Targeting cancer cells directly with antibodies. Monoclonal antibodies are laboratory-made proteins that lock onto specific markers on cancer cells, flagging them for immune destruction or blocking signals the cancer needs.
• Boosting the overall immune response. Cytokines and certain vaccines stimulate the immune system more broadly.
• Killing cancer cells while triggering immune attention. Oncolytic viruses are modified viruses that infect cancer cells, destroying them and drawing the immune system to the site.

One important consequence of how immunotherapy works is that response can be slower than with chemotherapy. The treatment is not directly killing cancer cells — it is mobilising the immune system to do so. It can also continue to work for some time after the treatment itself has stopped, because the immune response, once activated, can persist.

Who Receives Cancer Immunotherapy?

Immunotherapy is now part of standard treatment for many cancers. The list grows as new evidence emerges and new drugs are approved. Some of the cancers in which immunotherapy plays an established role include:

• Skin cancers — particularly advanced or metastatic melanoma, where checkpoint inhibitors have substantially changed long-term outcomes for many patients. Certain non-melanoma skin cancers, including Merkel cell carcinoma and some squamous cell skin cancers, are also treated this way.
• Lung cancer — non-small cell lung cancer (NSCLC) and small cell lung cancer, where checkpoint inhibitors are used alone or with chemotherapy.
• Kidney (renal cell) cancer — often using combinations of checkpoint inhibitors, or a checkpoint inhibitor with targeted therapy.
• Bladder and urothelial cancers.
• Head and neck cancers.
• Liver cancer (hepatocellular carcinoma).
• Some gastrointestinal cancers — including certain stomach, oesophageal, and colorectal cancers, especially those with specific molecular features such as microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR).
• Cervical and endometrial cancers in specific situations.
• Triple-negative breast cancer in selected stages and with specific tumour markers.
• Blood cancers — including certain lymphomas, leukaemias, and multiple myeloma, where monoclonal antibodies and CAR T-cell therapies play important roles.

Whether immunotherapy is appropriate for a particular patient depends on several factors:

• The cancer type and stage. Some immunotherapies are approved only for advanced or metastatic disease; others are used after surgery to reduce recurrence risk (adjuvant therapy) or before surgery to shrink the tumour (neoadjuvant therapy).
• Tumour testing results. Many immunotherapies work better — or are only used — when the tumour shows certain markers. Examples include PD-L1 expression, microsatellite instability status, tumour mutational burden, and specific genetic features. The tumour sample (biopsy) is tested in the laboratory before treatment is chosen.
• Previous treatments. Immunotherapy may be a first-line treatment or used after other therapies have stopped working.
• Overall health and other conditions. Patients with active autoimmune disease, those on long-term high-dose steroids, or those with a history of organ transplant may need very careful evaluation, because immunotherapy can worsen autoimmune conditions or affect transplanted organs.

Major oncology societies, including ASCO, ESMO, and NCCN, publish detailed guidelines on which immunotherapy regimens are used for which cancers. Your oncologist will draw on these guidelines and on the specific features of your cancer to plan treatment.

Types of Cancer Immunotherapy

Immunotherapy is an umbrella term for several treatment classes. The main groups in use today are described below.

Immune checkpoint inhibitors

This is the most widely used class of immunotherapy. Checkpoint inhibitors are antibodies that block proteins which act as “off switches” for T cells. By blocking these switches, the drugs allow the immune system to continue attacking cancer cells.

The most common checkpoints targeted are:

• PD-1 (programmed death-1) on T cells — targeted by drugs such as pembrolizumab, nivolumab, and others.
• PD-L1 (the partner protein found on many tumours) — targeted by drugs such as atezolizumab, durvalumab, and avelumab.
• CTLA-4 — targeted by ipilimumab.
• LAG-3 and others — newer checkpoints, sometimes combined with PD-1 inhibitors.

Checkpoint inhibitors are given as intravenous infusions, usually every two, three, four, or six weeks depending on the drug and dose. Treatment can continue for many months or even up to two years if the cancer is responding and side effects are manageable.

CAR T-cell therapy and other cell therapies

CAR stands for chimeric antigen receptor. In CAR T-cell therapy, a patient’s own T cells are collected from the blood, sent to a laboratory, and modified so that they carry a new receptor on their surface. This receptor is designed to recognise a specific marker found on the cancer cell. The modified cells are then grown in large numbers and infused back into the patient.

The CAR T-cell therapy process from blood collection through laboratory engineering to patient reinfusion.

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CAR T-cell therapy is mainly used in certain blood cancers — including some types of B-cell lymphoma, acute lymphoblastic leukaemia, and multiple myeloma. Research in solid tumours is ongoing.

Other cell therapies include tumour-infiltrating lymphocyte (TIL) therapy, in which immune cells already inside the tumour are extracted, expanded, and reinfused, and natural killer (NK) cell therapies. These are newer and are offered in fewer centres.

Cell therapies are intensive treatments. They typically require hospitalisation, careful monitoring for serious side effects, and a specialised care team.

Monoclonal antibodies

Monoclonal antibodies are laboratory-made versions of the antibodies the immune system produces. They are engineered to lock onto a specific target. Some monoclonal antibodies count as immunotherapy because they trigger or harness an immune response. Others are considered targeted therapy because they work by directly blocking a signal the cancer needs — in practice, the categories overlap.

Examples relevant to immunotherapy include:

• Rituximab — targets CD20 on B cells; used in some lymphomas and leukaemias.
• Trastuzumab — targets HER2; used in HER2-positive breast and stomach cancers (often classed as targeted therapy but also engages the immune system).
• Daratumumab — targets CD38; used in multiple myeloma.
• Antibody-drug conjugates — antibodies linked to a chemotherapy molecule, delivering the drug directly to cancer cells.
• Bispecific antibodies — engineered to bind both a cancer cell and a T cell at the same time, bringing the two together.

Cancer vaccines

Cancer vaccines aim to teach the immune system to recognise cancer-specific markers. They are different from the vaccines used to prevent infections, although some vaccines, like the HPV vaccine, do help prevent cancers caused by viruses.

Therapeutic cancer vaccines — designed to treat existing cancer — are still a relatively small part of cancer care, with approved uses in specific situations such as certain prostate cancers and early-stage bladder cancer (BCG, a long-established immune-stimulating treatment, falls in this broader category). Research into personalised tumour vaccines, including mRNA-based vaccines tailored to the individual tumour’s mutations, is active.

Cytokines

Cytokines are signalling proteins that immune cells use to communicate. Laboratory-made versions can boost the immune response.

• Interferons — once widely used in melanoma and some blood cancers, now used less often as newer drugs have become available.
• Interleukin-2 (IL-2) — high-dose IL-2 has produced long-lasting responses in some patients with melanoma and kidney cancer, but side effects are significant and use has narrowed.

Oncolytic virus therapy

Oncolytic viruses are modified to infect and kill cancer cells while sparing healthy ones. As the cancer cells die, they release antigens that draw the immune system to the area. Talimogene laherparepvec (T-VEC), used in some melanoma cases by direct injection into skin lesions, is an example.

Immune system modulators and adjuvants

This is a small group of medicines, including BCG used in early-stage bladder cancer, and certain immune-stimulating drugs applied locally for specific situations.

The Treatment Plan and What to Expect

Once your oncologist has recommended immunotherapy, several steps usually follow.

Before treatment begins

Before the first dose, you will typically have:

• Tumour testing. If not already done, the biopsy sample is tested for markers that predict response, such as PD-L1, microsatellite instability, or specific gene changes.
• Baseline blood tests. These check kidney, liver, and thyroid function; blood counts; and sometimes hormone levels.
• Baseline imaging. CT, MRI, or PET scans document the size and location of the cancer so that response can be measured later.
• Heart and lung assessment in some cases, especially if certain combinations or CAR T-cell therapy are planned.
• A detailed health review. Your team will ask about autoimmune conditions, infections (including hepatitis B and C, HIV, tuberculosis), past organ transplant, vaccinations, and current medications, including any steroids or immunosuppressants.
• Counselling on side effects. Because immune-related side effects can affect any organ, you will be given information about warning signs and contact numbers to use if symptoms develop.

How treatment is given

Most immunotherapies are given as intravenous (IV) infusions in a day-care unit. Each session may last from about thirty minutes to a few hours, depending on the drug and whether it is being given alongside chemotherapy. Some monoclonal antibodies are now available as subcutaneous injections.

A patient receiving an intravenous immunotherapy infusion in a hospital day-care unit.

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For checkpoint inhibitors, the schedule may be every two, three, four, or six weeks. Treatment often continues for many months. Some patients stay on treatment for up to two years; others stop earlier if the cancer responds well or if side effects require a break.

CAR T-cell therapy follows a very different schedule. After T cells are collected from the blood (a process called leukapheresis), the cells go to a laboratory for engineering, which takes several weeks. During this time, you may receive bridging treatment to keep the cancer stable. Before the engineered cells are infused, you usually have a short course of chemotherapy (lymphodepletion) to prepare the body. The infusion itself is a single event, but you stay in hospital or close to the centre for at least two to four weeks because of the risk of significant side effects in the early days after infusion.

During each infusion

The infusion itself is usually straightforward. The nurse monitors your pulse, blood pressure, and temperature. Some patients have mild reactions during or shortly after the infusion — chills, fever, rash, or feeling unwell — that can be managed with medicines.

Side Effects and How They Are Managed

Immunotherapy side effects are different from chemotherapy side effects. They are called immune-related adverse events (irAEs), and they happen because the immune system, once activated, can attack healthy tissues as well as cancer.

Human body outline indicating the organ systems that can be affected by immune-related adverse events.

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Most patients tolerate immunotherapy reasonably well, but side effects can affect any organ and can sometimes be serious or even life-threatening if not recognised early. Reporting symptoms quickly is important.

Common and important side effects

• Fatigue. Tiredness is one of the most common complaints. It can be persistent and can affect daily life.
• Skin changes. Rash, itching, dry skin, and sometimes more serious skin reactions.
• Diarrhoea and colitis. Inflammation of the colon can cause loose stools, abdominal pain, and blood in the stool. Untreated colitis can be dangerous.
• Thyroid problems. The thyroid gland can become underactive or, less commonly, overactive. This is usually manageable with hormone replacement.
• Pneumonitis. Inflammation of the lungs can cause cough, breathlessness, or chest discomfort. This can be serious and needs prompt treatment.
• Hepatitis. Inflammation of the liver, usually detected on blood tests before symptoms appear.
• Other hormonal problems. The pituitary and adrenal glands can be affected, sometimes requiring lifelong hormone replacement.
• Joint and muscle pain. Inflammation of joints or muscles.
• Kidney inflammation (nephritis), often detected on blood tests.
• Heart inflammation (myocarditis), uncommon but serious.
• Neurological side effects. Including weakness, numbness, balance problems, and rarely more severe nervous system inflammation.

Side effects specific to CAR T-cell therapy

CAR T-cell therapy has its own distinct pattern of early side effects:

• Cytokine release syndrome (CRS). A surge of immune signalling chemicals that causes fever, low blood pressure, breathing difficulty, and sometimes organ effects. It usually appears in the first one to two weeks after infusion and is managed with specific medicines and, in some cases, intensive care.
• Neurological side effects, sometimes called ICANS (immune effector cell-associated neurotoxicity syndrome). Symptoms can include confusion, difficulty speaking, tremor, headache, or, rarely, seizures. These need urgent treatment.
• Low blood counts and infections in the weeks after treatment, because of the lymphodepleting chemotherapy and the effect of the CAR T cells on healthy B cells.

Because of these risks, CAR T-cell therapy is given only in specialised centres with experienced teams, and patients are kept close to the hospital for several weeks.

How side effects are managed

Major oncology societies, including ASCO, ESMO, NCCN, and the Society for Immunotherapy of Cancer, have published detailed guidelines on managing immune-related side effects. The general principles are:

• Early recognition. Patients and families are taught to report new symptoms promptly. Many side effects start as mild changes that are easier to treat early.
• Holding or stopping the drug. For moderate to severe side effects, immunotherapy is paused. In some cases it can be restarted once the side effect has resolved.
• Steroids. Most moderate to severe immune-related side effects are treated with corticosteroids such as prednisolone or methylprednisolone, which calm the immune response.
• Additional immune-suppressing medicines. For side effects that do not respond to steroids, drugs such as infliximab, mycophenolate, or tocilizumab may be used.
• Hormone replacement. For thyroid, adrenal, or pituitary problems, hormone replacement is often needed and may be permanent.
• Specialist input. Gastroenterologists, pulmonologists, endocrinologists, cardiologists, and others may be involved depending on the organ affected.

One important point: side effects can appear weeks or months after immunotherapy has started, and sometimes even after treatment has ended. Continuing to mention any new symptom to your oncology team, even after you have stopped treatment, is important.

Response and Monitoring

Two graphs comparing pseudoprogression and true progression patterns of tumour size over time during immunotherapy.

AI-generated illustration

Because immunotherapy works through the immune system, the timing and pattern of response can be different from other treatments.

How response is measured

Response is usually tracked with imaging scans (CT, MRI, or PET) repeated every two to three months during treatment, along with blood tests and clinical review. For some cancers, tumour markers in the blood are also followed.

Imaging is interpreted with care. With immunotherapy, tumours can sometimes appear to grow slightly before they shrink — a pattern called pseudoprogression, caused by immune cells flooding into the tumour. Less commonly, real growth can occur (hyperprogression). Your oncologist may use clinical signs, symptoms, and repeat imaging to tell these apart, rather than acting on a single scan.

What kinds of responses occur

Responses to immunotherapy fall into several patterns:

• Complete response — all visible cancer disappears on scans.
• Partial response — significant shrinkage of the cancer.
• Stable disease — the cancer is not growing and not shrinking measurably.
• Progressive disease — the cancer is growing despite treatment.

An important and often-discussed feature of immunotherapy is that responses, when they occur, can be durable — lasting months or years, and in some cancers continuing even after treatment is stopped. For some patients with previously hard-to-treat advanced cancers, this has meant long-term disease control that was rarely seen with older treatments. At the same time, not every patient responds. Predicting who will respond is an active area of research; tumour markers help, but they are not perfect.

How long treatment continues

Decisions about continuing or stopping immunotherapy depend on:

• Whether the cancer is responding
• Side effect burden
• The specific drug and its approved duration
• Whether the patient has reached a planned treatment limit (often around two years for checkpoint inhibitors in advanced disease, but this varies)

If the cancer progresses on immunotherapy, your oncologist may discuss changing to a different immunotherapy combination, returning to chemotherapy or targeted therapy, considering radiation, surgery, or a clinical trial.

Combining with Other Treatments

Immunotherapy is often combined with other treatments to improve results.

• Chemotherapy plus immunotherapy. Now a standard approach in many lung cancers, some breast cancers, and other situations. Chemotherapy can kill cancer cells and release antigens, which may help the immune response.
• Two immunotherapies together. Combinations of a PD-1 inhibitor and a CTLA-4 inhibitor, or of PD-1 with a newer checkpoint blocker, are used in melanoma, kidney cancer, and other cancers. They often improve response rates but also raise the risk of side effects.
• Immunotherapy with targeted therapy. Combinations of checkpoint inhibitors with drugs that block tumour blood vessel growth (anti-angiogenic drugs) are standard in some kidney and liver cancers.
• Immunotherapy with radiation. Radiation may make tumours more visible to the immune system. Several combinations are used or under study.
• Immunotherapy with surgery. Increasingly, immunotherapy is given before surgery (neoadjuvant) to shrink tumours and reduce recurrence, or after surgery (adjuvant) to lower the risk of the cancer coming back.

Each combination has its own evidence base, schedule, and side effect profile. Your oncologist will explain the rationale for the specific combination proposed.

Living During and After Treatment

Going through immunotherapy is different for every patient. Some people feel close to their usual self for much of the treatment; others have more demanding side effects that affect daily life.

Day-to-day during treatment

Most patients can continue many regular activities during immunotherapy, including work, driving, exercise, and time with family. Practical considerations include:

• Energy levels. Fatigue is common. Planning rest, gentle activity, and avoiding overcommitment helps. Light exercise — walking, stretching, simple resistance work — is generally encouraged unless your team has advised otherwise.
• Diet. No specific “immunotherapy diet” is established. A balanced diet, adequate protein, and good hydration are sensible. Tell your team if you are taking probiotics or high-dose supplements, since some research suggests gut bacteria may influence immunotherapy response.
• Vaccinations. Most inactivated vaccines, including seasonal influenza, are safe and often advised. Live vaccines are usually avoided during and shortly after treatment. Discuss timing of any vaccines with your oncologist.
• Infections. Standard precautions — hand washing, avoiding close contact with people who are unwell, prompt review if fever develops — apply.
• Mental health. Anxiety, low mood, sleep changes, and uncertainty about scans are common. Counselling, peer support, mindfulness practices, and talking openly with family help many patients. Speak to your team if mood symptoms are significant; help is available.
• Sexual and reproductive health. Effects on fertility differ by treatment. Discuss contraception, pregnancy planning, and fertility preservation with your team before treatment if relevant.

What to watch for and when to call

Because immune-related side effects can develop quickly and affect any organ, your team will give you specific guidance on symptoms to report. In general, contact your oncology team promptly for:

• New or worsening breathlessness, cough, or chest pain
• Persistent diarrhoea, blood in the stool, or severe abdominal pain
• Yellowing of the eyes or skin, dark urine, or pale stools
• Severe fatigue, dizziness, low blood pressure, or fainting
• New weakness, numbness, confusion, difficulty speaking, or seizures
• Fever, especially above 38°C
• Rash that is spreading, blistering, or affecting the mouth or eyes
• Unusual swelling, palpitations, or sudden weight changes

You should be given a card or contact number to use at any time. Do not wait for the next clinic visit if a symptom is concerning.

Life after treatment

If treatment is stopped because of good response, ongoing follow-up usually includes:

• Periodic scans and blood tests, less frequent over time
• Ongoing monitoring for late immune-related side effects, particularly hormonal changes
• Reviewing any hormone replacement medicines started during treatment, which are often continued long-term
• General cancer survivorship care — healthy lifestyle, age-appropriate screening for other cancers, vaccination updates, and mental health support

Many patients live well for years after immunotherapy. Some side effects, particularly hormone gland changes, can be permanent and require lifelong replacement, but these are usually manageable with simple medication.

Immunotherapy in Children

Cancer immunotherapy in children is a smaller but growing field. Childhood cancers differ from adult cancers, and the immunotherapies used in adults are not all directly applicable.

Areas where immunotherapy plays an established role in paediatric oncology include:

• CAR T-cell therapy for B-cell acute lymphoblastic leukaemia. This was the first CAR T-cell therapy approved and is used in children and young adults with relapsed or refractory disease.
• Monoclonal antibodies in neuroblastoma. Antibodies targeting GD2, a marker found on neuroblastoma cells, are used as part of treatment for high-risk disease.
• Checkpoint inhibitors in selected paediatric cancers, including certain lymphomas and tumours with specific molecular features such as mismatch repair deficiency.

Treatment of children with immunotherapy is generally carried out in specialised paediatric oncology centres. Side effects are broadly similar to those seen in adults, with attention to growth, development, hormonal effects, fertility, and long-term follow-up. Decisions about treatment usually involve the child’s oncologist, family, and sometimes a multidisciplinary tumour board with paediatric expertise.

Clinical trials are an important part of paediatric immunotherapy because the evidence base is still developing. If a trial is offered, the team will explain the purpose, the schedule, and the risks involved.

Frequently Asked Questions

Is immunotherapy the same as chemotherapy?

No. Chemotherapy uses medicines that directly damage cancer cells (and some healthy cells). Immunotherapy works through the immune system, helping it find and attack cancer cells. The side effects are different, and the way the body responds is different. Some patients receive both, often together.

How will I know if immunotherapy is working?

Your oncologist will track response with periodic scans, blood tests, and clinical review. Improvements may take weeks to months to show on scans. Sometimes scans show small initial growth followed by shrinkage. Your team interprets the pattern over time rather than reacting to a single scan.

Can immunotherapy cure cancer?

For some patients, immunotherapy can produce very long-lasting responses, and in advanced cancers that were previously hard to treat, this has changed expectations significantly. Whether a response qualifies as a “cure” depends on the cancer, the duration of remission, and the individual situation. Other patients respond for a time and then need further treatment, and some do not respond. Your oncologist can describe what is realistic for your specific cancer.

What if I have an autoimmune condition?

Immunotherapy can worsen autoimmune conditions such as rheumatoid arthritis, inflammatory bowel disease, psoriasis, lupus, or thyroid disease. This does not always rule out immunotherapy, but it requires careful evaluation. Decisions are made case by case, often with input from the relevant specialist. If you have an autoimmune condition, tell your oncology team in detail.

Are there any vaccines I should avoid during treatment?

Live vaccines are generally avoided during immunotherapy and for some time afterwards. Inactivated vaccines, including most seasonal influenza vaccines and many others, are usually safe and often encouraged. Confirm timing with your oncology team.

Can I take supplements or herbal medicines?

Some supplements and herbal medicines can affect the immune system or interact with cancer treatments. Tell your oncologist about everything you are taking. They can advise on what is reasonable to continue and what to pause.

How long will I be on treatment?

Duration varies widely. Checkpoint inhibitors are often continued for many months and, in some advanced cancers, up to about two years. CAR T-cell therapy is given as a single infusion, with follow-up afterwards. Adjuvant immunotherapy (after surgery) typically has a fixed duration of months to a year. Your oncologist will explain the plan for your specific regimen.

Will I lose my hair?

Most immunotherapies do not cause significant hair loss. If you receive chemotherapy alongside immunotherapy, hair loss may occur because of the chemotherapy.

Can I keep working during immunotherapy?

Many patients continue working, sometimes with adjusted hours or working from home around infusion days. Fatigue and side effects vary. Your team can help you plan around your specific schedule and energy.

Is immunotherapy available everywhere?

Several immunotherapies are widely available, while newer or specialised treatments — particularly CAR T-cell therapy and TIL therapy — are delivered only in centres with the necessary infrastructure and trained teams. Your oncologist can advise on what is available for your situation.

What happens if immunotherapy stops working?

Options after progression include changing to a different immunotherapy combination, returning to chemotherapy or targeted therapy, considering radiation or surgery for specific sites of disease, or joining a clinical trial. The right next step depends on the cancer type, what treatments have been used before, your overall health, and your preferences.

Conclusion

Cancer immunotherapy has changed what is possible in cancer care over the past fifteen years. By working through the immune system, it offers a different way of attacking cancer — and for many patients, the chance of durable responses that were unusual with older treatments. At the same time, immunotherapy is not the right choice for every patient or every cancer, the side effects can be serious and require careful management, and not everyone responds.

Decisions about whether to use immunotherapy, which type, in what combination, and for how long, depend on the specific cancer, tumour testing results, overall health, and what other treatments have been used. These decisions belong to a detailed conversation with your oncology team, supported by the latest guidelines from major oncology societies.

If you are entering, undergoing, or following up after immunotherapy, the most useful things you can do are to understand what you are being given, report new symptoms promptly, attend monitoring appointments, and ask questions when something is unclear. The treatment is most effective when patients and their care teams work closely together over the months and years of the cancer journey.