Biologic therapies uses the body's own systems and abilities to fight the cancer or heal healthy tissue after treatment. Most of these therapies take advantage of the body's immune system, either directly or indirectly, to fight cancer or to lessen the side effects that may be caused by some cancer treatments.

  • How does the immune system work?
  • How do biologic therapies work?
  • What are the major types of biologic therapies?
  • What are the side effects?
  • What Are the Major Types of Biologic Therapies?

    The most common biologic therapies include:

  • Interferons (IFN)
  • Interleukins (IL)
  • Colony-stimulating factors (CSF)
  • Monoclonal antibodies (mAb)
  • Interleukins

    Like IFNs, ILs occur naturally in the body and can be synthesized in a lab. ILs are named numerically as IL-1 through IL-18.

    IL-2 has been the most widely studied in cancer treatment. This type stimulates the growth and activity of many cancer-killing immune cells, including NK cells and cytotoxic T cells. In addition, IL-2 enhances antibody responses.

    Aldesleukin is an IL-2 that is used to treat metastatic kidney cancer and melanoma.

    Colony-stimulating Factors

    CSFs do not affect cancer cells directly. Instead, CSFs help stimulate the production of new red blood cells, white blood cells, and platelets. This is important because many cancer treatments can decrease the levels of blood cells, which increases the risk of infection, anemia, and bleeding problems. Stimulating blood cell production can help stimulate the immune system.

    Some examples of CSFs include:

  • G-CSF and GM-CSF—Increase the number of white blood cells, which reduces the risk of infection. They can also be used to stimulate the production of stem cells in preparation for stem cell or bone marrow transplants.
  • Erythropoietin—Increase the number of red blood cells and reduce the need for red blood cell transfusion.
  • Oprelvekin—Increase the number of platelets and reduce the need for platelet transfusions.
  • Monoclonal Antibodies

    Monoclonal antibodies (mAbs) are substances that are produced in a lab. The process involves injecting a mouse with cells for a certain type of human cancer. Once injected with the cancer cells, the mouse produces antibodies to fight against the cancer. These mouse antibodies are then combined with other lab cells to create hybrid cells to fight cancer.

    MAbs can be used in cancer treatment in a number of ways. They may:

  • React with certain types of cancer, to enhance the body's immune response
  • Be programmed to act against specific cell growth factors to interfere with the growth of cancer cells
  • Be linked to anticancer drugs, radioactive substances, other biologic therapies, or other toxins to tag the cancer cells and alert the immune system to destroy them
  • Possibly help destroy cancer cells in bone marrow (during the process of bone marrow transplant)
  • There are a number of mAbs available, such as:

  • Rituximab—used to treat non-Hodgkin's lymphoma
  • Trastuzumab—used to treat breast cancer when the tumor expresses excess amounts of a protein called HER-2
  • Cetuximab—used to treat colon and rectal cancers, as well as head and neck cancer
  • Panitumumab—used to treat colon and rectal cancers
  • Bevacizumab—used to treat a certain type of brain tumor, and kidney, colon, rectal, lung, and breast cancers
  • Alemtuzumab—used to treat chronic lymphocytic leukemia
  • Ipilimumab—used to treat melanoma
  • What Are the Side Effects?

    The side effects depend on the type of biologic therapy that is used.


    More common side effects include:

  • Flu-like symptoms—chills, fever, fatigue, headache, and muscle pain and joint pain
  • Gastrointestinal effects, such as nausea, vomiting, diarrhea, and decreased appetite
  • Other side effects include:

  • Red, dry, or itchy skin, with or without a rash
  • Low blood pressure, rapid heart rate, heart arrhythmia, fluid retention, and weight gain
  • Confusion, disorientation, drowsiness, lethargy, anxiety, depression, and irritability
  • Changes in blood cell counts that can lead to anemia, thrombocytopenia, eosinophilia, lymphopenia
  • Problems with kidney function
  • Hypothyroidism
  • Severe toxicities are associated with high doses of IL-2.

    Colony-stimulating Factors

    CSF therapy is generally well tolerated. The side effects are minimal. Bone pain is one of the most commonly reported side effects.

    Monoclonal Antibodies

    With mAbs, allergic reaction to mouse protein is a major concern. Rarely, the acute reaction can result in anaphylaxis, a severe, sometimes life-threatening, allergic reaction.

    More common side effects include:

  • Fever
  • Chills
  • Sweating
  • Discomfort
  • Nausea and vomiting
  • Itchiness
  • Difficulty breathing
  • Low blood pressure
  • A delayed toxicity that can occur is called serum sickness. Symptoms of serum sickness include:

  • Hives
  • Itchiness
  • Joint pain
  • Swollen glands
  • Flu-like symptoms