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Immunotherapy Treatment
Scientists and doctors at St. Jude work to find new and better ways to use immunotherapy.
Immunotherapy is a treatment that helps the body’s immune system fight disease. It can help treat cancer, certain infections, and other conditions.
St. Jude Children’s Research Hospital offers several types of immunotherapies. These include:
- Adoptive cell therapy: Uses immune cells from your child or a donor to treat cancer and some infections.
- Allogeneic stem cell transplant: Replaces a patient’s blood-forming cells and immune cells with healthy cells from a closely matched donor.
- CAR T–cell therapy: Changes immune cells in a lab so they can better find and destroy cancer cells.
- Donor lymphocyte infusion (DLI): Uses immune cells from a donor to help rebuild the immune system after a bone marrow transplant.
- Virus-specific T cells (VSTs): Uses T cells from a donor that are prepared in a lab to help fight certain viral infections.
- Antibody therapy: Uses proteins that help the immune system better identify cancer cells.
- Immune checkpoint inhibitor therapy: Uses medicines that block signals that might prevent immune cells from attacking cancer cells.
- Cytokine therapy: Uses chemical signals that help stimulate the immune system.
- Cancer vaccines: Help train the immune system to prevent infections that may increase the risk of certain cancers, such as HPV and hepatitis B.
Your child’s care team may use immunotherapy with other treatments. These may include chemotherapy, radiation, or a bone marrow transplant. Using more than one type of treatment is called combination therapy.
Your child’s care team will recommend the treatment that is best for your child.
Brody’s family chose a clinical trial that included immunotherapy as part of his treatment. This approach was designed to help reduce the risk of his cancer returning.
Diseases treated with immunotherapy at St. Jude
Immunotherapy can treat some childhood cancers and infections. These include:
- Some types of leukemia and lymphoma that have come back or have not responded to treatment
- Solid tumors
- Brain and spinal cord tumors
- Some viral infections
Why St. Jude for immunotherapy?
- St. Jude has one of the largest immunotherapy research programs in the United States.
- At the Center of Excellence for Pediatric Immuno-Oncology, scientists and doctors work to make immunotherapy better for children with cancer. They develop treatments for some of the toughest childhood diseases, including brain and solid tumors.
- Children receiving CAR T–cell therapy are cared for by experts in the St. Jude Transplant Program. The program is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) for transplantation and immunotherapy.
- St. Jude is the only National Cancer Institute–designated Comprehensive Cancer Center just for children. A Comprehensive Cancer Center meets rigorous standards for research that develop new and better approaches to prevent, diagnose, and treat cancer.
- We lead more clinical trials for childhood cancer than any other hospital in the U.S.
- St. Jude doctors and staff have extensive experience caring for children with rare diseases.
- Lab and care teams work closely together. This can help doctors find a disease quickly and watch how well the treatment works.
- The nurse-to-patient ratio at St. Jude is about 1:3 in hematology and oncology and 1:1 in the Intensive Care Unit.
- The Transplant Unit at St. Jude specializes in the care of patients who get transplants or immunotherapy.
- We are consistently ranked among the best childhood cancer centers in the nation by US News & World Report.
- At St. Jude, we have created an environment where children can be children and families can be together.
- St. Jude patients and families never pay for services authorized by St. Jude.
- Patients may be able to get expert, compassionate care and treatment closer to their homes through the St. Jude Affiliate Program.
Your immunotherapy team
Your child’s care team includes doctors, nurses, and other specialists who are experts in diagnosing and treating serious childhood diseases.
Your child may also get support from experts in:
What to expect during your visit
Your child’s health care team will explain the treatment plan. They will talk to you about:
- The type of treatment your child will get
- When treatment will happen
- How treatment will be given
- What to expect during and after treatment
The exact steps depend on the type of immunotherapy your child gets.
Before treatment, your child may have blood tests, imaging scans, or other tests to help the care team plan treatment. For example, if your child is getting cells transplanted from a donor, a donor must be found and their cells tested to see if they are a good match. Your child may also need other tests and evaluations to see if they are ready for a transplant.
Immunotherapy may be given:
- Through an IV or central line
- By mouth as a pill, liquid, or capsule
- As a shot under the skin or into a muscle
- Into the bladder
- Into a tumor
- As a cream on the skin
During treatment, your child's care team will:
- Check your child's health regularly
- Watch how well the treatment is working
- Look for any side effects
- Answer your questions and provide support
Some children receive immunotherapy in the hospital. Others receive treatment in a clinic and go home the same day.
Tell your care team if your child feels unwell or if you notice any changes in how your child feels.
Immunotherapy side effects
Side effects depend on the type of immunotherapy your child gets.
Your child’s care team will watch your child closely. They will tell you which side effects to look for and what to do if they happen.
Ask questions and share any concerns with your child’s care team. If your child will be in a clinical trial, then asking questions and sharing any concerns can help you better understand the treatment and what to expect.
Some side effects of immunotherapy may feel like a cold or the flu. They may include:
- Fever
- Chills
- Body aches
- Rash
- Dry skin
- Itching
- Feeling very tired
Other side effects may include:
- Swelling or weight gain
- Headaches or confusion
- Blood pressure changes
- A fast, pounding, or fluttering heartbeat
- Trouble breathing
- Loss of appetite
- Nausea or vomiting
- Diarrhea
- Low oxygen levels
Some types of immunotherapy can cause severe side effects that worsen quickly. These include cytokine release syndrome and tumor lysis syndrome (TLS). These problems can be life-threatening if not treated right away. Ask your care team what signs and symptoms to watch out for and what to do if you see them.
You know your child best, so trust your intuition. If something does not seem right, tell your care team right away.
Immunotherapy clinical trials
St. Jude offers immunotherapy clinical trials for children, teens, and young adults. Learn more about clinical research at St. Jude.
Study goal:
The purpose of this study is to find the highest dose of CD70+ CAR cells that is safe to give to patients with CD70+ blood cancers.
Age:
Up to 21 years old
Study goal:
The main purpose of this study is to find the highest dose of CD123-CAR T cells that is safe to give patients with AML. We also want to study the side effects of the treatment and learn how effective it is in fighting this type of cancer.
Diagnosis:
Age:
21 years old or younger
Study goal:
The main goal of this study is to learn the largest dose of memory CAR T cells that can be safely given. Researchers also want to learn about the way memory CAR T cells act in the body and how effectively they treat this type of cancer.
Diagnosis:
Age:
Donor: At least 19 years old; Recipient: 21 years or younger
Study goal:
The main purpose of 3CAR is to find out if this type of immunotherapy is safe for pediatric patients with solid tumors. We also want to learn if it is effective in fighting solid tumors.
Diagnosis:
Age:
Up to 21 years old
Study goal:
In Part 1 of this study, we will see if sorafenib, cyclophosphamide, bevacizumab, and atezolizumab can be given safely together without causing serious side effects. Part 2 of the study will find out how well these medicines work in hepatocellular carcinoma, fibrolamellar carcinoma, desmoplastic small round cell tumors, and malignant rhabdoid tumors.
Diagnosis:
Solid tumors, hepatocellular carcinoma, fibrolamellar hepatocellular carcinoma, sarcomas, malignant rhabdoid tumors, desmoplastic small round cell tumors
Age:
1-30 years old
Study goal:
To study whether using memory T cells and blinatumomab in a special type of haploidentical stem cell transplant is safe and supports immune recovery in patients with blood cancers.
Diagnosis:
Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome, Chronic Myeloid Leukemia
Age:
Birth to 21 years
Study goal:
To study CAR T-cell therapy and chemotherapy agents for treating relapsed or hard-to-treat acute lymphoblastic leukemia.
Diagnosis:
Age:
Up to age 21
Study goal:
To study the safety of combining N-803 with chemotherapy and immunotherapy for relapsed and refractory neuroblastoma. To study whether N-803 plus chemotherapy and immunotherapy works better than chemotherapy plus immunotherapy alone.
Diagnosis:
Age:
Up to 30 years
Study goal:
To study subcutaneous blinatumomab in children with relapsed, refractory, or minimal residual disease–positive B-cell acute lymphoblastic leukemia to understand safety, dosing, and how well the treatment works.
Diagnosis:
Age:
28 days through 11 years
Study goal:
To improve patient and family health-related quality of life by addressing uncertainty and optimizing symptom management for patients who had CAR T-cell therapy.
Diagnosis:
Age:
12–25 years old
Study goal:
To study the side effects of CAR T cells, find the safest and most effective dose, see how long the CAR T cells last in the body, and find out how well the therapy works in people with refractory or relapsed acute lymphoblastic leukemia.
Diagnosis:
Acute lymphoblastic leukemia
Age:
Up to age 21
Study goal:
To compare the effects of adding inotuzumab and blinatumomab to standard chemotherapy during treatment for newly diagnosed ALL and LLy; to learn whether the length of time that inotuzumab stays in the body affects treatment success or side effects; to learn more about the biological and genetic or genomic traits that predict treatment success and toxicity in children.
Diagnosis:
B-cell acute lymphoblastic leukemia, lymphoblastic leukemia, lymphoblastic lymphoma (Non-Hodgkin lymphoma)
Age:
1-18 years
Study goal:
To study CD19 CAR T cells after allogeneic stem cell transplant for highrisk CD19positive ALL.
Diagnosis:
Age:
Up to 21 years
Study goal:
To study cabozantinib and cemiplimab to learn whether these agents can better treat advanced adrenocortical tumor and help slow or stop the disease.
Diagnosis:
Age:
12–19 years
Study goal:
To study the long-term effects of CD19-CAR T-cell therapy on survivors of B-cell acute lymphoblastic leukemia
Diagnosis:
Study goal:
To study B7-H3 CAR T cells combined with chemo and radiation for relapsed or refractory pediatric sarcoma. Learn more.
Diagnosis:
Osteosarcoma, Ewing sarcoma, Rhabdomyosarcoma, Non-Rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS), Alveolar Soft Part Sarcoma, Chondrosarcoma, Synovial Sarcoma
Age:
Up to 21 years
Study goal:
To study subcutaneous blinatumomab for B-cell acute lymphoblastic leukemia in patients age 12 years and older
Diagnosis:
Age:
12 years and older
Study goal:
To test the addition of blinatumomab and venetoclax to standard chemotherapy for infants with newly diagnosed B-cell acute lymphoblastic leukemia (ALL), specifically focusing on infants with KMT2A-rearranged (KMT2A-R) ALL.
Diagnosis:
Age:
Up to 1 year old
Study goal:
To study intermediate and long-term side effects of CAR-T cell therapy
Diagnosis:
Study goal:
To find out what effects adding nivolumab to chemotherapy has on people with newly diagnosed NPC.
Diagnosis:
Nasopharyngeal carcinoma
Age:
21 years old or younger
Study goal:
To find out whether adding dinutuximab with chemotherapy, early in treatment, treats high-risk neuroblastoma better than adding it later with chemotherapy.
Diagnosis:
Neuroblastoma or ganglioneuroblastoma
Age:
Up to 30 years old
Study goal:
To study NK cells, chemotherapy, and immunotherapy for treating relapsed or refractory neuroblastoma
Diagnosis:
Age:
1–31 years
Study goal:
To study B7‑H3 CAR T cells given after standard therapy to reduce relapse risk in high‑risk osteosarcoma.
Diagnosis:
Age:
0–21 years