About Lymphoma

Immunotherapy

Immunotherapy is a type of cancer treatment which assists the body’s immune system to fight cancer. Cancer cells can suppress immunity, which may contribute to the immune system’s failure to recognize cancer cells as foreign invaders.

There are many different ways that immunotherapies work to help our immune systems recognise and kill cancer cells.

On this page:

Overview of immunotherapy

Immunotherapies can also be known as ‘targeted therapies’ or ‘biological therapies‘. This is because they target different parts of the immune cells, pathways that allow the cells to grow and divide.

The immune system can then continually adapt to the cancer over time and provide a durable, long term response to the cancer. The immune cells called antibodies can remember, recognize and kill cancer cells in the future.

How do they work?

There are different kinds of immunotherapy and they work in different ways. Immunotherapy can boost the immune system to work better against cancer or remove barriers to the immune system attacking the cancer.

Immunotherapy takes advantage of a person’s own immune system to help kill cancer cells. Immunotherapy treatments help fight the lymphoma by giving the immune system a long-lasting memory.

Immunotherapies can be given as a single treatment or it can be given in combination with chemotherapy, called chemoimmunotherapy.

When are they used?

Immunotherapy treatments are used for lymphoma types which have been shown to respond to them.

Immunotherapy is not suitable for everyone. The doctor will consider:

  • Overall health
  • Lymphoma subtype
  • If the lymphoma has spread (the stage)
  • Treatment history

Types of immunotherapy

Antibody therapy

There are different types of antibody therapies that work slightly differently. They are known as monoclonal antibodies, bispecific monoclonal antibodies and include antibody drug conjugate therapies. There are immune system proteins created in the lab that are designed to bind to specific targets on cancer cells. Some antibody therapies mark cancer cells so that they will be better seen and destroyed by the immune system. Some examples of antibody therapies include:

  • Rituximab (MabThera)
  • Obinutuzumab (Gazyva)
  • Ofatuzumab (Arzerra)
  • Brentuximab vedotin (Advertis)
  • Polatuzumab (Polivy)
  • Alemtuzumab (Campath)
  • Mosunetuzumab
For more info see
Antibody therapy
For more info see
Targeted therapies

What are the common side effects of immunotherapy?

Side effects from immunotherapy can vary depending on the type of treatment that has been given and how the patient’s body responds. The side effects of checkpoint immunotherapy are different from those of other cancer treatments.

Common side effects include:

  • Fever
  • Chills
  • Weakness
  • Dizziness
  • Nausea or vomiting
  • Fatigue
  • Shortness of breath
  • Headache
  • Low or high blood pressure
  • Muscle and joint pain

Common immunotherapies used for some lymphoma subtypes

Below is a sample of some of the common subtypes of lymphoma and some of the monoclonal antibody and targeted therapies that are either currently being used in Australia (in bold) or are currently being investigated in clinical trials .

Subtype of lymphoma

Medicine

Chronic lymphocytic leukaemia (CLL)/small lymphocytic leukaemia (SLL)

Obinutuzumab

Ofatuzumab

Rituximab

Ibrutinib

Idelalisib

Venetoclax

Acalabrutinib

Zanubrutinib

CAR T-cell therapy

Mosunetuzumab

Diffuse large B cell lymphoma (DLBCL)

Rituximab

CAR T-cell therapy

Polatuzumab

Lenalidomide

  

Follicular lymphoma

Obinutuzumab

Rituximab

Ibrutinib

Idelalisib

Lenalidomide

CAR T-cell therapy

Hodgkin lymphoma

Pembrolizumab Brentuximab vedotin

Nivolumab

CAR T-cell therapy

Primary mediastinal B-cell lymphoma

Rituximab

Pembrolizumab

CAR T-cell therapy

Mantle cell lymphoma

Rituximab

Ibrutinib

Lenalidomide

venetoclax

Zanubrutinib

Acalabrutinib

Mosunetuzumab

Umbralisib

CAR T-cell therapy

Marginal zone lymphoma

Rituximab

Ibrutinib

Idelalisib

Umbilisib

Lenalidomide

Skin lymphoma

Brentuximab vedotin

Romidepsin

Vorinostat

Systemic anaplastic large cell lymphoma

Brentuximab vedotin

T-cell lymphoma

Brentuximab vedotin

Lenalidomide

Romidepsin

Belinostat

Waldenström’s macroglobulinaemia

Ibrutinib

Idelalisib

Bortezomib

Acalabrutinib

Zanubrutinib

Dr Michael Dickinson, Lead for aggressive lymphoma, Peter MacCallum Cancer Centre

Dr Michael Gilbertson, Monash Health

Prof John Seymour, Director of Haematology, Peter MacCallum Cancer Centre

Prof John Seymour, Director of Haematology, Peter MacCallum Cancer Centre

Prof Constantine Tam, Lead of indolent lymphoma, Peter MacCallum Cancer Centre

A/Prof Chan Cheah, Sir Charles Gairdner Hospital, Hollywood Private Hospital & Director of Blood cancer WA

Dr Michael Dickinson, Lead for aggressive lymphoma, Peter MacCallum Cancer Centre

Dr Ken Micklethwaite, Westmead Hospital

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