Our immune system, if treated properly, can not only prevent certain diseases but also treat them: it is called immunotherapy, a method of treatment based on the use of substances that activate and strengthen the immune system, inducing it to attack sick cells from within. In oncology, good results have been achieved over the last four years in the treatment of lung cancer, kidney cancer and some intestinal tumors, and there are also interesting prospects for the treatment of brain, bladder and liver tumors.

We are far from developing a single vaccine against cancer, but there is one thing the researchers agree on: the future of the fight against cancer will depend on the use of immunotherapy. Professor Alberto Mantovani, Scientific Director of Humanitas, a guest in the studio at The Hour of Health on La7, spoke about this.


How was immunotherapy detected?

First of all, we have better understood what happens to the immune system of patients arriving in hospital. In a cancer patient, two things have essentially happened: part of the immune defense has passed to the enemy, they are cells of innate immunity that behave like corrupt policemen and help all aspects of the tumor. Another part of the defenses is asleep and corrupt policemen administer sleeping pills to good, potentially active cancer cells. This revolution in the way we look at cancer has paved the way for developing therapeutic strategies. Today we use antibodies to treat patients with tumors in the blood, breasts and intestines. We have identified the brakes that act on the immune system and by removing them we have had a very important impact on some cancers,” explains Prof. Mantovani.


How does immunotherapy work?

Traditional approaches aim to kill the tumor cell, while immune system approaches aim to awaken the immune defenses that have activated its breaks. These approaches are making a difference, for example in the treatment of melanoma, although there is still a lot of work to be done.

Immunotherapy will not replace other approaches, but will complement them, so we will have to learn to use the combination of chemotherapy, targeted therapies and immunotherapy in a rational way.


Vaccines against cancer

In fact we have two vaccines against cancer, one is against the human papilloma virus, which prevents cancer of the cervix in women as well as head, neck and anal cancers in men. The second vaccine is against the hepatitis B virus, which is responsible for part of the liver cancers. We also hope for new preventive vaccines. The scientific challenge, however, is to use cancer vaccines in a therapeutic context,” says Prof. Mantovani.


Immunotherapy in rheumatology

Immunotherapy also plays an important role in the treatment of rheumatic diseases. Professor Carlo Selmi, Head of Rheumatology at Humanitas, explains: “We define immunotherapy as any therapeutic approach that modulates the response of the immune system. On one hand we can try to increase the response of the immune system and on the other hand – as in rheumatology – we try to reduce it, aiming for specific mechanisms of chronic inflammatory response”.

Immunotherapy represents, compared to traditional therapies of chemical synthesis, a radical change because it affects the mechanisms – and not the results – of inflammation. It’s a huge step forward.