Immunotherapy Side Effects

Widely gaining recognition as the fourth modality of cancer, immunotherapy has proven to be an effective line of treatment for a wide range of cancers. Immunotherapy primarily focuses on strengthening the immune system and its responses to identify and attack the cancer cells in the body. The main function of the immune system is to identify any aberrant cells and eliminate them from the body. Since immunotherapy boosts the immune system it usually results in milder side effects which can be effectively managed. Although this doesn’t mean that side effects are not present at all. Let us take a close look at these side effects for different types of cancers. 

Allergy Immunotherapy Side Effects 

Gaining wide recognition as an alternative to allergy shots, sublingual immunotherapy (SLIT) have gained popularity in their ability to provide some much needed relief from allergies. This type of immunotherapy works by exposing your body to small amounts of substances to which a person is allergic. This type of immunotherapy can help with a variety of airborne allergens such as pet dander, tree and grass pollen and molds. This type of immunotherapy poses several side effects such as –

  • Lip, mouth and tongue irritation. 
  • Nausea, vomiting, abdominal cramping and diarrhea. 
  • Itching or redness in the eyes. 
  • Increased severity of asthma symptoms. 
  • Skin reactions such as hives, itching or swelling. 

Immunotherapy Side Effects For Liver Cancer

Immune checkpoint inhibitors, which are a class of immunotherapy drugs, are commonly employed in the treatment of liver cancer. PD-1 and PD-L1 checkpoint inhibitors target PD-1 and the PD-L1 checkpoint protein on the surface of T-cells. When these drugs attach themselves to these proteins, they operate something similar to an “off switch” that essentially tells the T-cell to leave the other cell alone. By binding with the PD-1 and the PD-L1 protein, these drugs essentially boost the immune responses of the body thereby leaving it better equipped to target and attack the cancer cells in the body. Immune checkpoint inhibitors for liver cancer can pose several side effects. Some of these side effects include – 

  • Fatigue
  • Fever
  • Cough 
  • Nausea
  • Itching
  • Skin Rash
  • Loss Of Appetite
  • Muscle Or Joint Pain
  • Constipation

Apart from this, there may also be the possibility of infusion reactions after the administration of these drugs. An allergic reaction can include fever,chills, flushing of the face, rash, itchy skin, feeling dizzy and trouble breathing. There is also the possibility of an autoimmune reaction occurring due to these drugs. In some cases the immune system starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver or other organs of the body. It is important that a patient consults their oncologist once they notice these signs and symptoms because they can be severe if they go unnoticed. 

Immunotherapy Side Effects For Bladder Cancer

Bladder cancer is any neoplasm that arises or occurs in the urinary bladder of the body and is the most commonly occurring neoplasm of the urinary system. Urothelial carcinoma is the most commonly prevalent histological type of bladder carcinoma with nearly 90% of the patients attributed to this histological type. Early stage bladder cancer is often treated with immunotherapy, with BCG (Bacillus Calmette-Guerin) conducted to determine the extent of the cancer. Checkpoint Inhibitors are commonly employed to treat bladder cancer.  Some possible side effects of immunotherapy for bladder cancer include –

  • Mild pain or burning in your bladder
  • Feeling the need to urinate often
  • Pain when you urinate
  • Bloody urine or blood clots in the urine
  • Skin changes
  • Fatigue
  • Nausea
  • Allergic reactions
  • Constipation

Side Effects For Small Cell Lung Cancer

One of the two main classifications of cancer, small cell lung cancer accounts for 14% of all cancer cases (stat as per SCLC begins when the healthy cells of the lungs change and grow out of control and form a mass commonly understood as a mass, lesion or a nodule. This type of cancer begins in the neuroendocrine cells which are a type of hormone producing cells of the lungs. The term ‘small cell’ is used to signify the size and shape of the cancer cells as seen under a microscope. There are types of immunotherapies that are employed in the treatment of small cell lung cancer and each of them bring out different side effects. Some of the side effects of checkpoint inhibitors in the treatment of lung cancer include – 

  • Fatigue
  • Nausea
  • Itching 
  • Skin Rashes
  • Loss of Appetite


Cancer vaccines, which are a type of immunotherapy can also be used in the treatment of small cell lung cancer. Cancer vaccines target proteins that are present on cancer cells. Sometimes, these vaccines specifically target proteins that are unique to a patient’s cancer. An antigen is a substance that kick-starts the immune response of the body to start acting against that cancer cell. Cancer vaccines help the immune system to identify these antigens and ultimately attack the cancer cells in the body. The Denvax Clinics, located all over India utilizes dendritic cells to curate  cancer vaccines for their patients. The procedure uses a patient’s own mononuclear cells which are then cultured in cytokines and other nutritional media. Once these immature dendritic cells attain maturity, they are then administered to the patient via IV infusion. Some possible side effects of cancer vaccines include –

  • Anorexia
  • Back pains
  • Chills
  • Headache
  • Jointache

Immunotherapy Side Effects On The Thyroid

While immune checkpoint inhibitors have proven to be effective against a wide range of cancers, they have also proven to result in problems associated with the thyroid gland. Hypothyroidism, which is a condition essentially characterized by low levels of the thyroid hormones, is a common side effect that can occur in patients who are on checkpoint inhibitors. Along with this, thyroid dysfunction is another problem that can arise due to the use of checkpoint inhibitors. Along with this, it needs to be noted that this side effect pertaining to the thyroid gland can be permanent for many patients. It is not clear why problems associated with the thyroid gland may appear after the intake of checkpoint inhibitors but experts have a few possible explanations for this as well. One possible explanation for this is that there may be some mildly undiagnosed thyroid dysfunction before being diagnosed with cancer itself. So, in a sense these checkpoint inhibitors could activate an underlying disposition. Another possible explanation is that cancer patients are taking other medication that interferes with normal thyroid function. 

Immunotherapy Side Effects For Allergic Rhinitis

When the immune system overreacts to foreign substances such as pollen and causes symptoms like blood shot eyes and a runny nose, it is referred to as allergic rhinitis. Immunotherapy allergy treatments can help to remove symptoms associated with this ailment. Immunotherapy can help to reduce or eliminate these symptoms by gradually altering the immune system’s response to allergens. Due to this the immune system fails to respond to these allergens as they previously used to and this then helps to remove the symptoms associated with this disease. 

Some of the side effects associated with immunotherapy for allergic rhinitis include – 

  • Mild Swelling.
  • Itching.
  • Redness At The Injection Site. 
  • Low Blood Pressure
  • Rash
  • Vomiting

How Long Do Immunotherapy Side Effects Last

Usually, the side effects of immunotherapy wane off by the time a treatment cycle ends. Many side effects will go away once the treatment cycle ends however there some side effects may last for an extended period of time. It is important that patients continue getting care for these side effects even after this treatment ends. 

Final Note

Immunotherapy has emerged as the fourth modality in the last decade and like any other line of treatment it also presents various side effects. While these side effects are often mild, it is imperative that patients keep an eye on these side effects. Patients should consult their oncologists and healthcare team if these side effects are severe and continue to persist.

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