Which cancers can be treated with immunotherapy?

Last updated on May 21, 2021

Immunotherapy is a treatment option for a growing number of cancers. Unlike traditional treatments like chemotherapy and radiation therapy, immunotherapies do not target the cancer itself.

“At times, our immune system can become tolerant to cancer for various reasons,” says Aung Naing, M.D., who leads an immunotherapy working group in MD Anderson’s Phase I clinical trials program. “With immunotherapy, we are trying to harness or reinvigorate the immune system so that it recognizes and attacks the cancer instead of being tolerant.”

What are the different types of immunotherapy?

There are several types of immunotherapy. Immune checkpoint inhibitors work by blocking checkpoint proteins – including CTLA-4, PD-L1 and PD-1 – on the surface of T cells. These proteins normally prevent T cells from attacking healthy cells. Approved checkpoint inhibitors include:

• anti-CTLA-4 therapy ipilimumab
• anti-PD-1 therapies pembrolizumab, nivolumab, cemiplimab and dostarlimab
• anti-PD-L1 therapies atezolizumab, avelumab and durvalumab

Adoptive cellular therapies are another form of immunotherapy. The only Food and Drug Administration (FDA)-approved options are CAR T cell therapies, which are created from T cells taken from the patient. The cells are engineered to better recognize the cancer, expanded to large numbers and given back to the patient. FDA-approved CAR T cell therapies include brexucabtagene autoleucel, tisagenlecleucel, axicabtagene ciloleucel and lisocabtagene maraleucel.

Cancer vaccines train the body to recognize specific features of the cancer and stimulate the immune system to attack. The only approved cancer vaccine is sipuleucel-T.

Finally, cytokine therapies rely on immune proteins called interferons and interleukins to stimulate immune activity. The main cytokines that have been approved for cancer treatment are interleukin-2 and interferon alpha.

Immunotherapy treats many types of cancer

Currently, the FDA has approved immunotherapies to treat certain patients with the cancer types listed below. The list is expanding frequently as more immunotherapy drugs complete testing through clinical trials. So, if immunotherapy isn’t an option for you right now, that could change in the future.

“We are constantly evaluating therapies in new cancer types and testing new therapies that have not been used before,” says Naing.

In most cases, patients must have had previous treatment with certain treatments or have specific tumor markers in order to be eligible for these therapies. Keep in mind that the information shared here should not be considered medical advice. “It’s important to talk to your doctor to determine whether you may be eligible for immunotherapy or to address specific medical questions or concerns,” Naing says.

Advanced solid tumors

Certain children and adults with advanced solid tumors and specific tumor characteristics may be eligible for treatment with the immune checkpoint inhibitor pembrolizumab, regardless of cancer type.

B-cell lymphoma

For some children and adults with B-cell lymphoma, the following immunotherapy treatments may be an option:

• Certain adults with advanced large B-cell lymphoma may be eligible for CAR T cell therapy with tisagenlecleucel, axicabtagene ciloleucel or lisocabtagene maraleucel.
• Certain adults with mantle cell lymphoma may be eligible for brexucabtagene autoleucel CAR T cell therapy.
• Certain adults with advanced follicular lymphoma may be eligible for axicabtagene ciloleucel CAR T cell therapy.
• Certain adults and children with primary mediastinal B-cell lymphoma may be treated with pembrolizumab.

Bladder cancer

Several checkpoint inhibitors have been approved to treat certain patients with locally advanced or metastatic bladder cancer. Approved drugs include pembrolizumab, atezolizumab, nivolumab, durvalumab and avelumab in certain indications. Nivolumab in combination with the targeted therapy cabozantinib is approved as a first-line treatment in some patients.

Breast cancer

For some adults with locally advanced or metastatic triple-negative breast cancer, immune checkpoint inhibitors may be an option. The FDA has approved treatment with atezolizumab in combination with the chemotherapy paclitaxel (protein-bound) and pembrolizumab in combination with chemotherapy. 

Cervical cancer

Certain patients with recurrent or metastatic cervical cancers may be eligible for treatment with the immune checkpoint inhibitor pembrolizumab.

Colorectal cancer

Immune checkpoint inhibitors may be an option for certain patients with advanced colorectal cancer with specific tumor markers, including pembrolizumab and nivolumab (either alone or in combination with ipilimumab).

Esophageal cancer

For some patients with squamous cell esophageal cancer, the immune checkpoint inhibitors pembrolizumab and nivolumab may be an option.

Certain patients with esophageal cancer or gastroesophageal junction cancer may be treated with immune checkpoint inhibitors:

• For some patients with resectable cancer, the FDA has approved treatment with nivolumab. 
• Certain patients with advanced cancers may be treated with pembrolizumab or nivolumab combined with certain chemotherapies.

Head and neck cancers

Certain patients with advanced squamous cell cancer of the head and neck, such as oral cancer or throat cancer, may be eligible for treatment with the immune checkpoint inhibitors nivolumab or pembrolizumab. In some cases, pembrolizumab may be used alone or in combination with certain chemotherapies.

Hodgkin lymphoma

For certain patients with refractory classical Hodgkin lymphoma, the FDA has approved treatment with pembrolizumab and nivolumab.

Kidney cancer

Immune checkpoint inhibitors may be an option for certain patients with advanced kidney cancer. Either avelumab or pembrolizumab may be used in combination with the chemotherapy axitinib for some patients. Nivolumab may be used alone or in combination with ipilimumab for some patients.

The cytokine therapies interferon alpha, in combination with the targeted therapy bevacizumab, or interleukin-2 may also be options for some patients.

Leukemia

Tisagenlecleucel CAR T cell therapy is an option for some children and young adults with refractory B-cell acute lymphoblastic leukemia. The cytokine therapy interferon alpha may also be an option for some patients with certain leukemias.

Liver cancer

Certain patients with liver cancer may be treated with the immune checkpoint inhibitors pembrolizumab, nivolumab (alone or in combination with ipilimumab), or atezolizumab in combination with the targeted therapy bevacizumab.

Lung cancer

Certain patients with advanced non-small cell lung cancer may be eligible for treatment with immune checkpoint inhibitors, including nivolumab (alone or with ipilimumab), pembrolizumab, atezolizumab, durvalumab and cemiplimab. In some circumstances, these therapies are only approved for treatment in combination with certain chemotherapies or targeted therapies.

Some patients with advanced small cell lung cancer also may be eligible for treatment with pembrolizumab, nivolumab, atezolizumab or durvalumab. Atezolizumab and durvalumab are used in combination with specific chemotherapies.

Melanoma

Immune checkpoint inhibitors have been approved for certain patients with advanced melanoma. These include pembrolizumab, ipilimumab and nivolumab (alone or with ipilimumab). Atezolizumab is approved in combination with certain targeted therapies.

The cytokine therapies interferon alpha or interleukin-2 may also be options for some patients.

Mesothelioma

For some patients with unresectable malignant pleural mesothelioma, the FDA has approved treatment with ipilimumab in combination with nivolumab.

Multiple myeloma

Certain patients with advanced multiple myeloma may be treated with the CAR T cell therapy idecabtagene vicleucel.

Non-Hodgkin lymphoma

Some patients with relapsed or refractory B-cell non-Hodgkin lymphoma may be eligible for treatment with the immunotherapy:

• Certain adults with advanced large B-cell lymphoma may be eligible for CAR T cell therapy with tisagenlecleucel, axicabtagene ciloleucel or lisocabtagene maraleucel.
• Certain adults with mantle cell lymphoma may be eligible for brexucabtagene autoleucel CAR T cell therapy.
• Certain adults with advanced follicular lymphoma may be eligible for axicabtagene ciloleucel CAR T cell therapy.
• Certain adults and children with primary mediastinal B-cell lymphoma may be treated with pembrolizumab.

The cytokine therapy interferon alpha may also be an option for some patients with certain non-Hodgkin lymphomas.

Prostate cancer

Some patients with metastatic castration-resistance prostate cancer may be treated with the therapeutic vaccine sipuleucel-T.

Skin cancer

Treatment with immune checkpoint inhibitors is approved for some patients with skin cancer:

• Pembrolizumab and avelumab has been approved for adults and children with Merkel cell cancer. 
• Pembrolizumab and cemiplimab has been approved for some patients with cutaneous squamous cell cancer.
• Cemiplimab has been approved for certain patients with basal cell carincoma.

Stomach cancer

Certain patients with recurrent locally advanced or metastatic stomach cancer or gastroesophageal junction cancer may be eligible for treatment with the immune checkpoint inhibitors pembrolizumab or nivolumab plus certain chemotherapies.

Endometrial cancer For some patients with advanced uterine cancer, treatment with checkpoint inhibitors may be an option:

• Pembrolizumab has been approved in combination with the targeted therapy lenvatinib for certain patients with advanced endometrial cancer.
• Dostarlimab has been approved for certain adults with recurrent or avanced endometrial cancer.

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