Biological Therapy

• Biological therapy uses substances made from living organisms to treat diseases by targeting specific immune responses or cellular processes.
• These therapies work by mimicking or blocking natural biological processes, such as immune cell activity or specific protein functions.
• Common types include monoclonal antibodies, vaccines, gene therapies, and cell therapies, used across oncology, autoimmune diseases, and more.
• While highly effective, biological therapies can cause side effects, including infusion reactions, infections, and autoimmune responses.
• Patients considering biological therapy should discuss potential benefits and risks thoroughly with their healthcare provider.

What is Biological Therapy?

What is biological therapy? It is a form of treatment that uses the body’s own immune system to fight cancer and other diseases, or to replace missing substances in the body. These therapies are often referred to as biologics, and they are typically much larger and more complex than conventional drugs. They are engineered to target specific molecules or cells involved in disease, offering a more precise approach compared to traditional treatments that might affect a broader range of cells. This targeted action can lead to more effective treatment with potentially fewer systemic side effects.

How Biologics Work and Their Types

Biologics function by interacting with specific components of the immune system or other biological pathways to restore normal function, block disease progression, or directly attack diseased cells. Their mechanisms are highly specific, making them powerful tools in treating complex conditions.

Mechanisms of Action

Understanding how biological therapy works involves recognizing their diverse mechanisms. Many biologics are designed to mimic natural substances in the body, such as antibodies, growth factors, or enzymes. For instance, some biologics are monoclonal antibodies that can specifically bind to cancer cells or immune cells, marking them for destruction or blocking signals that promote disease growth. Others might enhance the body’s immune response against specific threats, while some replace deficient proteins, like insulin or clotting factors, to manage chronic conditions.

Common Categories of Biologics

The types of biological therapy are diverse and continue to expand with scientific advancements. They can be broadly categorized based on their structure and function:

• Monoclonal Antibodies (mAbs): These are laboratory-produced molecules engineered to serve as substitute antibodies that can restore, enhance, or mimic the immune system’s attack on cancer cells or other disease-causing agents. They are widely used in oncology, autoimmune diseases, and inflammatory conditions.
• Vaccines: While traditionally used for prevention, therapeutic vaccines are a type of biologic designed to stimulate the immune system to fight an existing disease, such as certain cancers or chronic infections.
• Growth Factors: These biologics stimulate the growth and differentiation of specific cell types, often used to help the body recover from chemotherapy or to treat conditions like anemia.
• Gene Therapies: These involve introducing genetic material into a person’s cells to replace faulty genes, introduce new genes to fight disease, or modify existing genes.
• Cell Therapies: This category includes treatments like CAR T-cell therapy, where a patient’s own immune cells are modified in the lab to better recognize and attack cancer cells, then reinfused into the patient.
• Enzyme Replacement Therapies: Used for genetic disorders where the body lacks a specific enzyme, these biologics provide the missing enzyme to restore normal metabolic function.

Potential Side Effects of Biological Therapy

While generally well-tolerated and highly effective, biological therapy side effects can occur due to their interaction with the immune system and other biological processes. The specific side effects vary greatly depending on the type of biologic and the condition being treated, but some common reactions include:

• Infusion-related reactions: These can occur during or shortly after the administration of the biologic and may include fever, chills, rash, headache, and shortness of breath. These are often managed by slowing the infusion rate or administering pre-medications.
• Increased risk of infection: Many biologics work by modulating the immune system, which can sometimes lead to a weakened ability to fight off infections. Patients may be more susceptible to bacterial, viral, or fungal infections.
• Autoimmune reactions: In some cases, biologics can trigger or worsen autoimmune conditions, as they interact with the immune system.
• Skin reactions: Rashes, itching, or injection site reactions (redness, swelling, pain) are common, especially with subcutaneously administered biologics.
• Fatigue and flu-like symptoms: General malaise, muscle aches, and fatigue are also reported by some patients.

Patients undergoing biological therapy are closely monitored for these and other potential adverse effects. It is crucial for individuals to discuss all potential risks and benefits with their healthcare provider and report any new or worsening symptoms promptly.