My Reports
RGCIRC, Niti Bagh
Immunotherapy Cancer Treatment in Delhi | RGCIRC
Overview
Cancer treatment has changed profoundly over the past two decades. Where surgery, chemotherapy, and radiation were once the primary tools available, a fourth approach has emerged that works differently from all three – immunotherapy. Rather than attacking cancer cells directly, immunotherapy works by activating and directing the body’s own immune system to fight and destroy them.
At RGCIRC (Rajiv Gandhi Cancer Institute and Research Centre), immunotherapy is offered as part of a fully integrated, multidisciplinary oncology programme. It is used across a growing range of cancer types, either as a standalone treatment or in combination with surgery, chemotherapy, or radiation, based on what the evidence supports for each individual patient’s diagnosis.
What is Immunotherapy and How Does it Work?
The immune system is the body’s primary defence against disease. It continuously monitors cells throughout the body, identifying and eliminating those that are abnormal. Cancer cells, however, have developed mechanisms to evade this surveillance – they disguise themselves, suppress immune signals, or create an environment that prevents immune cells from functioning effectively.
Immunotherapy works by disrupting these evasion mechanisms. Depending on the specific approach used, it may block the signals cancer cells use to hide from the immune system, introduce proteins that help immune cells recognise tumour tissue, enhance the number or activity of immune cells, or equip immune cells with new targeting capabilities. The result, in patients who respond, is an immune response directed specifically at the cancer, which the body’s immune cells then sustain over time.
This durable response is one of immunotherapy’s most significant clinical advantages. Unlike chemotherapy, which acts on cancer cells only during treatment, a successful immunotherapy response can persist long after the treatment course is complete, because the immune system retains a memory of the cancer cells it has been trained to target.
Types of Immunotherapy
Immunotherapy is not a single treatment. It is a broad category of approaches that engage the immune system through different mechanisms. The main types used in cancer care at RGCIRC include:
Immune Checkpoint Inhibitors
Checkpoint inhibitors are the most widely used class of immunotherapy drugs in oncology. Cancer cells can evade the immune system by exploiting regulatory proteins on immune cells, known as checkpoints, which normally act as brakes on immune activity.
Checkpoint inhibitors block these proteins, effectively releasing the brake and enabling immune cells to recognise and attack tumour cells.
The most well-established checkpoint targets are PD-1, PD-L1, and CTLA-4. Commonly used drugs in this class include pembrolizumab, nivolumab, atezolizumab, and ipilimumab.
Monoclonal Antibodies
Monoclonal antibodies are laboratory-engineered proteins designed to bind to specific targets on cancer cells or immune cells. Some monoclonal antibodies mark cancer cells for destruction by immune cells. Others carry a chemotherapy drug or radioactive particle directly to the tumour site, limiting damage to surrounding healthy tissue. Monoclonal antibodies are used across a wide range of cancer types and are among the most established forms of immunotherapy in clinical use.
CAR-T Cell Therapy
CAR-T (Chimeric Antigen Receptor T-cell) therapy involves extracting a patient’s own T-cells, genetically engineering them in a laboratory to recognise specific proteins on cancer cells, and reinfusing them. The modified cells then seek out and destroy cells carrying that protein. CAR-T therapy has demonstrated significant efficacy in certain blood cancers, including relapsed or refractory B-cell lymphomas and leukaemias, and is an area of active clinical development.
Cytokine Therapy
Cytokines are signalling proteins that regulate immune activity. Interleukins and interferons are the two main cytokine classes used in cancer treatment. They work by stimulating immune cell proliferation and activity. Cytokine therapy is used in specific indications including certain kidney cancers and melanoma, though it has largely been superseded by checkpoint inhibitors in many settings due to its side effect profile.
Cancer Vaccines
Therapeutic cancer vaccines are designed to stimulate the immune system against tumour-specific antigens – proteins expressed on cancer cells that are absent or rare on normal cells. Unlike preventive vaccines, therapeutic cancer vaccines are given to patients who already have cancer, with the goal of training the immune system to mount a targeted anti-tumour response. Personalised neoantigen vaccines, which target mutations unique to an individual patient’s tumour, represent an emerging and promising development in this area.
Combination Approaches
Immunotherapy is increasingly used in combination with chemotherapy, radiation, or targeted therapy. These combinations are supported by a growing evidence base showing improved outcomes in specific cancer types and stages compared to either modality alone. Treatment sequencing and combination selection are determined through multidisciplinary review at RGCIRC.
Cancers Treated with Immunotherapy at RGCIRC
Immunotherapy is now an established treatment across multiple cancer types. At RGCIRC, its use is guided by evidence-based protocols and multidisciplinary tumour board review to ensure appropriate patient selection.
The cancer types currently treated with immunotherapy at RGCIRC include:
Lung Cancer: Checkpoint inhibitors, particularly PD-1 and PD-L1 inhibitors, are used in both non-small cell and small cell lung cancer, in patients with high PD-L1 expression or in combination with chemotherapy.
- Head and Neck Cancers: Pembrolizumab and nivolumab are approved for recurrent or metastatic squamous cell carcinoma, especially in patients whose disease has progressed after platinum-based chemotherapy.
- Melanoma: Checkpoint inhibitors such as ipilimumab, nivolumab, and pembrolizumab have significantly improved outcomes in advanced melanoma and remain one of the most established uses of immunotherapy.
- Bladder Cancer: PD-1 and PD-L1 inhibitors are used in locally advanced and metastatic urothelial carcinoma.
- Kidney Cancer: Immunotherapy combinations, including dual checkpoint inhibition or checkpoint inhibitors with targeted therapy, are standard first-line options for advanced renal cell carcinoma.
- Liver Cancer: Atezolizumab combined with bevacizumab is an established first-line treatment for unresectable hepatocellular carcinoma.
- Colorectal Cancer: Checkpoint inhibitors are effective in a specific subset of colorectal cancers characterised by mismatch repair deficiency or high microsatellite instability.
- Hodgkin Lymphoma: PD-1 inhibitors have shown high response rates in relapsed or refractory classical Hodgkin lymphoma.
- Triple-Negative Breast Cancer: Pembrolizumab, combined with chemotherapy, is used in high-risk early-stage and metastatic disease with PD-L1 expression.
- Cervical Cancer: Pembrolizumab is approved for recurrent or metastatic cervical cancer with PD-L1 expression, and for MSI-H tumours irrespective of PD-L1 status.
Eligibility for immunotherapy is determined through biomarker testing, including PD-L1 expression, microsatellite instability status, and tumour mutational burden, alongside a comprehensive multidisciplinary evaluation of each patient’s condition and prior treatment history.
What to Expect During Immunotherapy Treatment
Immunotherapy is administered in different ways depending on the specific drug and cancer type. Understanding the treatment process helps patients prepare practically and emotionally for what the experience involves.
How Immunotherapy is Delivered
The main routes of delivery are as follows:
- Intravenous infusion: The most common delivery method for checkpoint inhibitors and monoclonal antibodies. The drug is administered through a drip into a vein, typically in a dedicated oncology daycare facility. Sessions last from 30 minutes to a few hours depending on the drug and protocol
- Intravesical: For bladder cancer, BCG immunotherapy is instilled directly into the bladder through a catheter
- Subcutaneous injection: Some immunotherapy formulations are given as injections under the skin
Treatment Schedule and Duration
Immunotherapy is typically given in cycles. The interval between infusions varies by drug: some are given every two weeks, others every three or four weeks. The duration of treatment depends on the cancer stage and type, the patient’s response, and whether the drug is being used as a standalone treatment or in combination with other modalities. Some patients receive immunotherapy for a defined period; others continue for as long as the treatment remains effective and tolerated.
Most immunotherapy infusions are administered on an outpatient basis. Patients do not require hospitalisation for the infusion itself, though monitoring in the clinic for a period after each infusion is standard practice to observe for infusion reactions.
Side Effects and Risk Management
Immunotherapy side effects differ in nature from those of chemotherapy. Because immunotherapy acts by stimulating the immune system, the side effects it causes are largely immune-mediated – the activated immune system can occasionally affect healthy tissues and organs as well as the tumour.
Common side effects that patients may experience include fatigue, skin rash or itching, diarrhoea, nausea, and infusion-related reactions at the time of drug administration, including fever, chills, headache, and muscle aches.
Immune-related adverse events are a more specific category of side effects caused by excessive immune activation affecting particular organs or systems. The organs most commonly affected are outlined below.
- Skin: Rash, itching, or vitiligo-like changes, typically the earliest and most frequently occurring immune-related effects
- Gastrointestinal tract: Colitis causing diarrhoea or abdominal pain, which may be severe and requires prompt management
- Lungs: Pneumonitis – inflammation of the lung tissue – which can cause breathlessness and requires careful monitoring and, if significant, treatment interruption
- Liver: Hepatitis causing elevated liver enzymes, usually detected on routine blood monitoring
- Endocrine glands: Thyroid dysfunction, adrenal insufficiency, or hypophysitis – inflammation of the pituitary gland – which may require hormone replacement
- Joints: Inflammatory arthritis in some patients
Most immune-related adverse events are manageable with dose adjustment, temporary treatment interruption, or corticosteroid therapy when required. Serious reactions are uncommon but need prompt clinical attention.
At RGCIRC, all patients receiving immunotherapy are closely monitored throughout their treatment. This includes regular blood tests and clinical evaluations to detect and manage side effects at an early stage.
Immunotherapy at RGCIRC
Immunotherapy at RGCIRC is delivered as an integral part of its medical oncology programme, led by experienced oncologists working within a coordinated multidisciplinary framework. Care is guided by clinical evidence, patient-specific factors, and close collaboration across specialties.
The key components of immunotherapy care at RGCIRC include the following:
Multidisciplinary Treatment Planning
Every patient is reviewed by the relevant tumour board before treatment begins. This brings together medical, surgical, and radiation oncologists, along with pathologists and radiologists, to confirm suitability for immunotherapy and to optimise its integration with other treatment modalities when required.
Biomarker Testing and Personalised Treatment
Eligibility for immunotherapy depends on the tumour’s molecular profile. RGCIRC offers in house PD-L1 expression testing, microsatellite instability and mismatch repair analysis, and next-generation sequencing for tumour mutational burden and broader profiling. These investigations guide treatment selection and help identify patients most likely to benefit.
Oncology Daycare and Infusion Facilities
Immunotherapy is administered through dedicated oncology daycare units, allowing patients to receive treatment and return home the same day. Each infusion is supervised by the oncology team, with appropriate post-infusion observation to detect early reactions.
International Patient Services
RGCIRC supports patients from across India and abroad seeking immunotherapy. Services include assistance with medical visas, teleconsultations for pre-treatment evaluation of reports, coordination of treatment schedules, and follow-up care after returning home. Patients may also request a remote multidisciplinary second opinion through the RGCI Care app.
Accreditation and Quality Standards
RGCIRC holds NABH (5th Edition) and NABL accreditations. All immunotherapy protocols follow current NCCN and international evidence-based guidelines and are regularly updated in line with evolving clinical evidence.
Immunotherapy at RGCIRC
If you have been advised to consider immunotherapy, or if you would like to discuss whether immunotherapy is appropriate for your diagnosis, our medical oncology team is available for consultation in person or via telemedicine.
Call +91-11-4702 2222 (Rohini) / +91-11-4582 2222 (Niti Bagh, South Delhi) Book online at care.rgcirc.org | Download the RGCI Care app on iOS and Android OPD Hours: Monday to Saturday, 9:00 AM to 5:00 PM | Emergency Services: 24×7 at both campuses
Frequently Asked Questions (FAQs)
What is immunotherapy for cancer?
Immunotherapy is a form of cancer treatment that works by activating or enhancing the body’s own immune system to recognise and destroy cancer cells. Unlike chemotherapy, which targets cancer cells directly, immunotherapy targets the mechanisms that cancer cells use to evade immune detection. It includes several distinct approaches, including checkpoint inhibitors, monoclonal antibodies, CAR-T cell therapy, and cancer vaccines.
Which cancers can be treated with immunotherapy?
Immunotherapy is approved for a growing range of cancers including lung cancer, melanoma, head and neck cancers, bladder cancer, kidney cancer, liver cancer, colorectal cancer with specific molecular features, Hodgkin lymphoma, triple-negative breast cancer, and cervical cancer. Eligibility depends on the specific subtype, stage, and molecular characteristics of the tumour, assessed through biomarker testing.
How long does immunotherapy treatment take?
Treatment duration varies by drug and cancer type. Infusion sessions typically last from 30 minutes to a few hours. Treatment cycles may be every two, three, or four weeks depending on the protocol. Some patients receive immunotherapy for a defined number of cycles; others continue for as long as the treatment remains effective. Your oncologist will outline the expected duration as part of your personalised treatment plan.
Is immunotherapy available for international patients at RGCIRC?
Yes. RGCIRC welcomes international patients seeking immunotherapy treatment. Services include telemedicine pre-treatment consultations, assistance with medical visa documentation, treatment scheduling coordination, and follow-up support for patients returning home after completing their course. To enquire about international patient services, contact the patient services team at info@rgcirc.org or call +91-11-4702 2222.
Can I have a telemedicine consultation with an immunotherapy specialist before travelling to RGCIRC?
Yes. RGCIRC offers telemedicine consultations for patients who wish to have their imaging and pathology reviewed before travelling for treatment. This can be arranged through the RGCI Care app on iOS and Android, or by contacting the patient services team directly.
What are the side effects of immunotherapy?
Common effects include fatigue, rash, diarrhoea, and infusion reactions. Immune-related effects may involve organs such as the skin, lungs, liver, or thyroid. Most are manageable with timely care and monitoring.
Is immunotherapy more effective than chemotherapy?
Not always. Effectiveness depends on cancer type and biomarkers. In selected cases, it offers better and longer-lasting responses. It is often used alongside chemotherapy rather than replacing it.
How much does immunotherapy treatment cost at RGCIRC?
The cost of immunotherapy varies depending on the drug used, the number of cycles required, and the cancer type being treated. Immunotherapy drugs vary considerably in price, and detailed cost estimates are provided following the initial consultation and treatment planning review. RGCIRC’s Philanthropy Department offers financial assistance for patients who require support accessing treatment.
Does RGCIRC offer follow-up care for international patients after they return home?
Yes. RGCIRC provides structured follow-up support for international patients who have completed treatment and returned to their home country. This includes telemedicine follow-up appointments, interpretation of post-treatment imaging and blood results, and guidance on ongoing management, coordinated through the international patient services team and the RGCI Care app.
Are there any waiting periods for immunotherapy treatment at RGCIRC?
Waiting times depend on the urgency of the clinical situation and the current scheduling of the relevant oncology service. Patients with urgent treatment needs are prioritised accordingly. To enquire about current availability and to schedule a consultation, contact the patient services team directly.