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44

NCCN Guidelines for Patients

®

Adolescents and Young Adults with Cancer, Version 1.2017

For example, the cycles can be 14, 21, or 28 days

long. These cycles, including days of rest, giving the

body a chance to heal in between treatments.

Immunotherapy

The immune system usually does a pretty good

job of defending your body against germs, viruses,

and parasites (as well as the occasional grain of

pollen). In theory, it should recognize cancer cells

as abnormal and attack them in the same way. But

cancer cells have ways of getting around the immune

system’s defenses.

Immunotherapies are designed to boost immune

activity. They help the immune system find and

attack cancer cells. Many immunotherapies are now

available and others are being studied to find new

ways to fight cancer using our immune system. Here

are a few examples of commonly used therapies:

††

Cytokines

(for example, interleukins or

interferons) boosts the activity of normal

proteins that control our immune system’s

response to cancer.

††

Monoclonal antibodies

—called MABs—

(for example, ipilimumab or rituximab) are

man-made types of proteins that attach to

the surface of cancer cells (kind of like a key

fitting into a lock). Once MABs link up with the

cancer cell, other immune cells are able to

recognize and attack the cancer.

††

Cancer vaccines

(for example, Sipuleucel-T)

act in the same way as vaccines do against

the flu or chicken pox. They teach the immune

system to recognize cancer cells so the

immune system can defend itself against the

cancer.

Targeted therapy

Unlike chemotherapies, which go after just about

any fast-dividing cell, targeted therapies seek out

how cancer cells grow, divide, and move in the body.

Targeted therapies are usually grouped on the basis

of what they do or the part of the cell they target.

††

Hormone modifiers

(for example, tamoxifen

or anastrozole) block the making or the

activity of estrogen. This is a hormone that

some cancers of the breast and uterus need

to survive.

††

Enzyme inhibitors

and

growth factor

inhibitors

(for example, trastuzumab or

erlotinib) block specific enzymes and growth

factors that cancer cells need to grow and

spread. These drugs may also be called

small-molecule drugs or signal transduction

inhibitors.

††

Apoptosis-inducing drugs

(for example,

bortezomib or pralatrexate) change parts of

the cancer cell that control survival and death,

causing the cell to kill itself. Apoptosis is

natural cell death.

††

Angiogenesis inhibitors

(for example,

bevacizumab or sunitinib) target growth

factors that allow cancer cells to build new

blood vessels. This cuts off the tumor’s blood

supply and basically starves it to death.

††

Antibody-drug conjugates

(for example,

ibritumomab tiuxetan) are a combination of

a MAB and a toxin or radioactive substance

(radiopharmaceutical) that enters and kills the

cell after the MAB latches on.

Because these drugs zero in on molecular targets

found mostly in cancer cells, targeted therapies are

less likely to damage healthy cells and cause side

effects.

5

Understanding your treatment options

What are systemic treatments?