Immunotherapy for Ovarian Cancer

Immunotherapy is a type of cancer treatment that helps the immune system find and attack cancer cells. There are many different types of immunotherapy, and they work in different ways. One type, called immune checkpoint inhibitors, can be used to treat advanced ovarian cancers that have certain features.

Immune checkpoint inhibitors for ovarian cancer

The immune system uses “checkpoints” to help keep it from attacking normal cells. These checkpoints are proteins on immune cells that are turned on or off to start an immune response. Cancer cells sometimes use these checkpoints to hide from the immune system. Immune checkpoint inhibitors are drugs that target these checkpoints to help the immune system find and attack cancer cells.

Pembrolizumab (Keytruda) and dostarlimab (Jemperli) target PD-1, a protein on certain immune cells called T cells that normally prevents them from attacking healthy cells. Blocking PD-1 boosts the immune response against cancer, which can shrink some tumors or slow their growth. These drugs may be used for advanced ovarian cancers that:

• Have high levels of microsatellite instability (MSI-H), meaning the cancer cells have many DNA copying mistakes, or changes in mismatch repair genes (dMMR) that affect the cells’ ability to fix those mistakes, and
• Have continued to grow after chemotherapy or other drug treatments

Pembrolizumab can also be used for advanced ovarian cancer with a high tumor mutational burden (TMB-H), meaning the cancer cells have many gene mutations.

These treatments are given as an intravenous (IV) infusion every 3 weeks.

Possible side effects of immunotherapy

Side effects of these drugs can include

• Fatigue
• Cough
• Nausea
• Loss of appetite
• Itching
• Skin rash
• Diarrhea or constipation
• Joint pain

Less often, more serious side effects occur, including:

• Infusion reactions: Some people have reactions during the infusion. Symptoms are similar to an allergic reaction and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. Tell your care team right away if you have any of these symptoms.
• Autoimmune reactions: These drugs remove a natural safeguard on the body’s immune system. As a result, the immune system may attack healthy parts of the body, causing serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.

It’s very important to report any new side effects to your cancer care team as soon as possible. If serious side effects do occur, treatment may need to be stopped and you may need high doses of corticosteroids to suppress your immune system.