Immunotherapy For Cancer: Principles, Effects, Costs and Fundings

Immunotherapy, also known as immuno-oncology, has received great attention and is considered a new hope in cancer treatment. The effectiveness of immunotherapy is well demonstrated through clinical trials in treating later-stage melanoma skin cancer. Melanoma patients who received the immunotherapy treatment had an overall survival rate of over 60% in two years. Scientists believed that its effectiveness rises when combined with other cancer treatments. The emergence of immunotherapy can stop cancer from spreading and help patients control their conditions even if the malignant tumours are not totally deterred.

Principles of Immunotherapy

To understand the principles of immunotherapy, let’s start with your immune system.

The immune system is made up of white blood cells and organs and tissues of the lymph system. It helps your body detect and fight bacteria, viruses and abnormal cells, including cancer cells.

Even though the immune system can prevent or slow cancer growth, cancer cells have ways to avoid destruction by the immune system. For example, cancer cells may have genetic changes or proteins on their surface to make them less visible to the immune system and even turn off immune cells.

Therefore, scientists invented immunotherapy to strengthen or adjust the operation and reaction of patients’ immune systems to better act against cancer.

How Is Immunotherapy Used to Treat Cancer?

There are several types of immunotherapy, including the commonly known immune checkpoint inhibitors and T-cell transfer therapy, intending to strengthen the immune system to destroy cancer cells. According to Cancer Research Institute, immunotherapy can:

• Educate the immune system to recognise and attack specific cancer cells
• Boost immune cells to help them eliminate cancer
• Provide the body with additional components to enhance the immune response

Immunotherapy unleashes the three unique powers of the immune system:

• Precision: The immune system is precise, so it can target cancer cells exclusively while sparing healthy cells.
• Self-adjustment: The immune system can adapt continuously and dynamically, just like cancer does, so if a tumour manages to escape detection, the immune system can re-evaluate and launch a new attack.
• Memory: The immune system’s “memory” allows it to remember what cancer cells look like, so it can target and eliminate cancer if it returns.

Immunotherapy Vs. Targeted Therapy

Immunotherapy and targeted therapy have evolved rapidly as alternative cancer treatments of conventional methods, such as surgeries, chemotherapy and radiotherapy. Said to be transforming cancer treatments, many have put these two therapies in comparison. Your doctors may adopt a stand-alone treatment or combine both methods to fight cancer according to your conditions.

	Immunotherapy	Targeted Therapy
Principles	Boost one’s immune system to fight against cancer.	Find and attack specific areas or substances in cancer cells (such as proteins); detect and block certain kinds of messages sent inside a cancer cell that tell it to grow.
Side Effects	With side effects similar to suffering from an autoimmune disorder	Skin rash; causing live and gastrointestinal problems
Limitations	Cancer cells are more likely to develop drug resistance	High cost of medicine and slow curative effect

Side Effects of Immunotherapy

Most side effects of immunotherapy are due to the stimulation posed on the immune system, causing slight inflammation and flu symptoms. However, for some serious cases, side effects akin to an autoimmune disorder may also be developed.

Common side effects of immunotherapy include:

• Skin problems (such as skin rash)
• Mouth ulcers
• Fatigue
• Nausea
• Arthritis or muscle aches
• Headache
• Changes in blood pressure
• Thyroid abnormalities
• Inflammation of the kidneys and liver

If you experience the above side effects, please consult your doctor as soon as possible for early intervention (such as prescribing steroids to reduce inflammation) to relieve your discomfort caused by the treatment.

Estimated Treatment Costs of Immunotherapy

Immunotherapy is effective but remains very expensive. According to a news article, an immunotherapy treatment (about two to three weeks) costs HK$ 60-70,000 at a private hospital, while HK$ 20-30,000 at a public hospital. The treatment costs can even be over a million per year. From a report, more than 70% of cancer patients said that the effect of immunotherapy is better than expected. However, the rocket-high costs lead to a drawback among the general public.

Government Funding for Immunotherapy in Hong Kong

If patients pass the financial tests, funds will be granted to purchase the immunotherapy drugs under the HA Drug Formulary for treating head and neck, skin, kidney and lung cancer.

The main objective of The Community Care Fund (CCF) is to provide assistance to people facing financial difficulties. Immunotherapy has been included in the subsidy coverage of the CCF Medical Assistance Programme since May 2020, for treating patients with stage III non-small-cell lung cancer. To be eligible for financial assistance, the patient must be an HA patient and fulfil all the clinical requirements.

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