1. What is immunotherapy?

    This is a process of enhancement of the innate immunity present in all individuals. Lymphocytes are the most important functioning components of this innate immunity, in which a part of them are Natural Killer (NK) cells and Dentritic Cells (DCs).  In Immunotherapy Lymphocytes, NK cells and DCs are taken from the patients own blood and then in the laboratory (in vitro) lymphocytes are activated, the NK cells as well as DCs are expanded, and then transfused back into their body.

2. How does it work?

The Lymphocytes are the first line of defence in our body against Cancer cells; specifically the NK cells and DCs. They are very efficient because they cause direct cell lysis (direct damage to cancer cells) and do not need activation by antibodies.

Normally only 5% - 10% of our body’s WBC is Natural killer cells. Here we activate the lymphocytes in general and expand it many fold so that once infused they will kill the cancer cells.

3. Can it be used for all cancers?

Yes it is applicable for all cancers in general. But very good results have been reported with Renal Cell cancer (Kidney), Malignant Melanoma (Skin), Advanced Pancreatic Tumours, Leukemias (Blood cancers), Lymphomas, Breast Cancer, Ovarian Cancer, Liver and Lung Metastasis etc.

4. What are the procedures involved before a patient can receiving immunotherapy?

a)  Blood is collected by a simple puncture of the vein as is done for any other lab test.

b) The collected blood is then processed in the specialized lab by specially trained scientists under highly sterile and aseptic techniques.

c)  The application of the famed Japanese technique (Technical Collaboration M/S Biotherapy Institute of Japan) in the culture of the cells will result in three events.

i.  Activation of Lymphocytes    ii.   Expansion of natural killer cells, iii.  Passive expansion of stem cells.

d) After the process is completed the cultured cells of the patient are readministered (Given Back) to the patients as an intravenous drip some 14-21 days after the blood was collected from him/her.

5.  Does the immunotherapy necessitate admission of the patients to a hospital?

The patient need not be admitted for collection of blood as it can be done as an outpatient procedure. But the patient has to be admitted for administering the cultured cells for about a day or two. 

6.       What are all problems that are anticipated during the administration of the cells?

 In general there are no major adverse effects. This is so because the patients are given back the cells that were originally collected from them. Therefore the infusion is well tolerated. But during the process of destruction of the cancer cells by the cultured cells that are transfused, the patient may experience fever/fatigue on the day of administration. The risk of this is however is small. It occurred in less than 1% of patients in a study population that included more than 1400 patients.

7. What precautions does NCRM take during the culture?

a)        The culture technique is sterile so as to ensure that no bacterial contamination takes place. This is also objectively tested by using ‘Endotoxin test’. If it is negative it implies that there is no bacterial contamination and only then will the cultured cells be administered to the patients.

b)       The collected cells will be subjected to IPT (Immunophenotyping) this is specially important for Blood cancers. After expansion the cultured cells will once again be subjected to IPT and only on fully satisfying ourselves that the desired cells are present they would be administered to the patients. IPT is done through a third party organization.

8. What is the success rate?

        As in the treatment of cancers by other methods the patients who come early do better. A study which compared patients who have undergone the conventional treatment alone (Group 1) with that of the patients who have undergone the Immunotherapy in addition to the conventional treatment (Group 2) a 38% better results with the of the patients of Group 2 has been reported.

9. What are the Dosage requirements and timing of administration?

         The dose is determined on a case to case basis. If the cancer is solid and has been removed completely by surgery 2 transfusions may be sufficient while 4 –6 Transfusions are required if the patients is receiving chemotherapy after surgery. 4 –6 Transfusions are required for blood malignancies. 

The timing for blood malignancies is when the patient is in remission.        The timing for solid cancer is just before the patient is to receive chemotherapy or after 1 week of the patient receiving chemotherapy. This is to ensure that a good amount of peripheral blood stem cells are available for the treatment process