Already 10 years of success

How the immune system is used against cancer

The tumor is the focus of the body's own immune system.

(Bild: stock.adobe.com/freshidea - stock.adobe.com)

Just over a decade ago, the first immuno-oncology therapy was approved and ushered in a revolution in cancer treatment. Since then, these treatment approaches, known as immunotherapies, have extended the lives of many people suffering from cancer and given them a new perspective. And the successful research continues!

Through continued intensive research and development, this form of therapy has now set the course for a new future: A time when cancer is seen much more as a chronic rather than a fatal disease. Survival rates and quality of life during treatment have increased dramatically in recent years.

More and more cancer patients
Nevertheless, the system faces a major challenge: by 2040, there will be twice as much demand for cancer treatment as there is today. This is because people, and therefore cancer patients, are getting older and older. But the good news is that research is booming: in 2023 alone, over 2,000 clinical trials on innovative cancer therapies were launched worldwide. 

Tumor grows "past" the immune system
Cancer is caused by genetic changes in cells that disrupt the balance between cell growth and degradation. The most common types of cancer in Austria include breast, lung, bowel and prostate cancer.

In a healthy body, the immune system successfully recognizes and destroys all cancer cells resulting from random mutations. Cancer occurs when the immune system malfunctions for some reason and malignant cells begin to actively divide and form a tumor - without being recognized by the immune system.

We are only at the beginning of this development. Thanks to the global commitment, many new substances have been and are being developed, and many have already found their way into the clinic.

Prim. Univ.-Prof. Dr. Wolfgang Hilbe, Klinik Ottakring, Wien

Strengthening the immune system
"In the past, we only had chemotherapy at our disposal and thought: more helps more. Today, we have learned a lot and introduced supportive treatments. We recognized how strong the immune system is and have learned to control this power over the past decade," explained oncologist Prim. Prof. Dr. Wolfgang Hilbe, Ottakring Clinic in Vienna, at a press conference.

So how does the revolutionary immunotherapy work? "It activates the body's own immune system to recognize and fight tumour cells. Unlike conventional approaches, such as chemotherapy or radiotherapy, which often damage healthy cells as well as tumor cells, immuno-oncology strengthens the body's own defenses to enable sustainable control of the disease," says the expert.

Was ist Immuntherapie?

Die Immuntherapie hilft dem Körper, besser mit Krebs umzugehen, indem sie entweder die natürliche Abwehr stärkt oder dem Immunsystem spezifische Werkzeuge an die Hand gibt, um Krebszellen gezielt anzugreifen. Zu den Formen der Immuntherapie gehören Checkpoint-Inhibitoren, CAR-T-Zelltherapien und Krebsimpfstoffe. Diese Behandlungen können allein oder in Kombination mit anderen Therapien wie Chemotherapie oder Strahlentherapie eingesetzt werden. Ziel ist es, das Immunsystem dazu zu bringen, den Krebs effektiver zu bekämpfen und das Wachstum der Tumoren zu verlangsamen oder zu stoppen.

Higher survival rates
Advances in cancer treatment, including immuno-oncology, have led to an enormous improvement in survival rates in some cases. At the same time, these treatments are proving to be well tolerated, which the experts had not originally expected. "Even though not everything is always easy for patients, of course, many can now live well and for a long time with the disease," says Prim. Hilbe.

Today, immuno-oncological therapies are also available for more and more different types of tumors, including rare and aggressive cancers.

Defeating skin cancer
Immunotherapy has been particularly successful with black melanoma (skin cancer). "If detected early, this type of cancer can be operated on quickly and thus treated. However, metastases occur in 20 percent of patients, as melanoma can spread anywhere in the body," explained AO Prof. Dr. Christoph Höller, Medical University of Vienna. Treatment is needed here. "One advantage is that the immune system can recognize this cancer well, as there is a high rate of genetic changes in the tumour. This helps the immune system to unmask these cells as not healthy."

Activate the immune system early
In the event of illness, it is always important to start treatment early. In order to be able to treat even more efficiently, experts are asking themselves whether immunotherapy would be useful in some cases, such as skin cancer, even before surgery. This would make it possible to use the important tumor environment, in which immune cells are also active, to defend against the tumor and not immediately remove it along with the malignant tissue.

Thomas Derntl, board member of the Alliance of Oncological Patient Organizations, Chairman of Multiple Myeloma Self-Help Austria and a patient himself, described how important these advances are for patients: "I wouldn't be standing here today without research successes. Just 13 years ago, survival rates for my cancer, multiple myeloma (a form of blood cancer), were said to be 3 to 4 years. Thanks to the dynamic developments in oncology and intensive research, many patients can now expect an indefinite life expectancy."

Nevertheless, not everyone responds to immunotherapies. Researchers are working to better understand the mechanisms and develop personalized treatment strategies. Prof. Hilbe: "However, I am optimistic that we will make further enormous progress in the coming years, which will enable us to develop and offer even more targeted therapies. The dream of making cancer curable is getting closer and closer."