From cell-manufacturing laboratories to outpatient infusion facilities, health systems are rapidly adapting to a new kind of cancer treatment that demands individualized care, infrastructure and training: immunotherapy.
To better navigate the complex and strategic considerations presented by immunotherapy, healthcare leaders need to understand what it is, how it’s being used and where the treatment is headed.
What is immunotherapy?
Simply put, immunotherapy harnesses a patient’s own immune system to identify and attack cancer cells. Debated by physicians and researchers for decades, immunotherapy officially gained acceptance within oncology during the 1980s and 1990s. After receiving a metastatic melanoma diagnosis at the age of 90, former President Jimmy Carter brought immunotherapy to a mainstream audience when he became one of the first public figures to speak openly about the treatment in 2015.
Recent advancements in the field have created — as W. Kimryn Rathmell, MD, PhD, CEO of Columbus-based Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital told Becker’s — a “fundamental shift” in cancer care.
“In metastatic kidney cancer, we used to teach that the disease was not curable, period. We would [tell] patients that, although we had options that could control the disease for a time, it was eventually going to be the cause of their death,” Dr. Rathmell said.
“Now that narrative is different. We have patients who … have the chance to achieve a normal life after cancer.”
How do hospitals offer immunotherapy?
Immunotherapy is an umbrella term for multiple therapeutic options, the most common being CAR-T cell therapy, immune checkpoint inhibitors, cytokines, monoclonal and bispecific antibodies, and personalized cancer vaccines. Each therapy leverages a different part of a patient’s own immune system against their unique cancer.
Immunotherapies are personalized for each patient and may be used as a first-line treatment or in combination with other treatments, such as chemotherapy. Immunotherapies are most often administered intravenously but might also be available as an injection, in pill or tablet form or as a topical application, and are typically given to patients every few weeks as part of a treatment cycle.
According to Houston-based University of Texas MD Anderson Cancer Center, though researchers continue to identify new use cases, immunotherapies are currently used to treat the following cancers: bladder, colorectal, esophageal, head and neck, kidney, leukemia, liver, lung, lymphoma, melanoma, multiple myeloma, nasopharyngeal cancer, sarcoma, stomach and triple-negative breast cancer.
How are health systems integrating immunotherapy services?
How immunotherapy services are offered depends on the type of immunotherapy being administered and the frequency with which treatment occurs. While health systems will continue to provide certain treatments on an inpatient basis at a hospital or cancer center, there has been a recent push to provide more cancer care services in the outpatient setting.
The Cancer Institute at Tampa (Fla.) General Hospital opened an outpatient Cellular-Immunotherapy Transplant Unit in December, enabling some CAR T-cell and bone marrow transplant patients to continue living at home during treatment.
In May, Salt Lake City-based Intermountain Health established a satellite CAR T-cell therapy clinic within its St. George (Utah) Cancer Center. Patients can visit the center for cell collection procedures which previously were available only at the Intermountain LDS Hospital in Salt Lake City.
After collection, cells are sent to a separate facility and re-engineered for each patient’s individualized treatment. Cell transplantation and post-procedure observation still occurs at the Intermountain LDS Hospital though some patients are eligible to return home for follow-up care.
What are the barriers to scaling immunotherapy?
“This is not just adding another drug to your pharmacy,” Renier Brentjens, MD, PhD, deputy director and the Katherine Anne Gioia Endowed Chair in Cancer Medicine at Buffalo, N.Y.-based Roswell Park Comprehensive Cancer Center told Becker’s. “This type of therapy, as good as it is, requires expertise on multiple levels. Hospital systems need to be prepared to do it very thoughtfully. It does require an investment of time and, as with anything, money.”
Roswell Park recently opened the GMP Engineering & Cell Manufacturing Facility, a $98 million cell and gene therapy hub aimed at growing the center’s capabilities for cancer cell therapy research.
In 10 years’ time, Dr. Brentjens said he envisions cell therapy will become its own subspecialty, where oncologists are trained in selecting the best cell product, and managing both treatment and post-infusion care.
As with most cancer treatments, immunotherapy is not without risk.
“When turned on, the immune system attacks the cancer but may also attack noncancerous tissue, producing side effects similar to autoimmune disease symptoms,” oncologist Svetomir Markovic, MD, PhD, said in a Feb. 26 article from Rochester, Minn.-based Mayo Clinic Comprehensive Cancer Center.
A serious but rare side effect of immunotherapy is immune checkpoint inhibitor-associated myocarditis, a type of heart inflammation. Though it only occurs in approximately 1% of patients undergoing immune checkpoint inhibitor therapy, of the patients who develop it — 50% will experience a dangerous cardiac event and about one-third will die from it.
Researchers from Boston-based Massachusetts General Hospital and Cambridge, Mass.-based Broad Institute of MIT and Harvard found evidence that the immune reaction in the heart is distinct from the immune response of the cancer tumor. This suggests the possibility of using targeted treatments to address checkpoint myocarditis, while allowing patients to continue immunotherapy treatment.
Is immunotherapy FDA approved?
According to the Cancer Research Institute’s “2025 Cancer Immunotherapy Insights + Impact Report,” the FDA has approved more than 150 immunotherapies since 2011, granting 17 immunotherapy approvals in 2024 alone.
In June, the FDA eliminated Risk Evaluation and Mitigation Strategies requirements for six CAR-T cell therapies: Abecma, Breyanzi, Carvykti, Kymriah, Tecartus and Yescarta, determining the program is no longer necessary to ensure the benefits of the therapies outweigh the risks.
How are health systems supporting immunotherapy research?
In the face of potential federal funding cuts to the National Institutes of Health, which supports the National Cancer Institute Cancer Centers Program, healthcare organizations are doubling down and banding together to strengthen the momentum behind immunotherapy innovation.
New York City-based Mount Sinai Health System launched a research partnership with the National Cancer Institute to uncover how and why the immune system responds — or doesn’t respond — to certain immunotherapies.
New York City-based Weill Cornell Medicine established a cancer research collaborative to explore ways to improve the effectiveness of immunotherapy through nutrition, metabolism and emerging therapeutics. The Weill Cancer Hub East connects leaders from Weill Cornell, Princeton (N.J.) University, New York City-based Rockefeller University and the Ludwig Institute for Cancer Research, also in New York City.
Weill Cornell and Mount Sinai are also members of the newly established Empire State Cellular Therapy Consortium, alongside Roswell Park Comprehensive Cancer Center, University of Rochester (N.Y.) Wilmot Cancer Institute and New York City-based NYU Langone Health. The consortium will collaborate to open several clinical trials within the next two years and expand patient access to FDA-approved cell therapies.
Duarte, Calif.-based City of Hope was awarded a contract of up to $23.7 million to study how advanced or metastatic non-small-cell lung cancer tumors change during immunotherapy treatment. The award will fund a six-year clinical trial across the system’s more than 35 clinical sites.
The new cornerstone of cancer care
Use of FDA-approved cancer immunotherapies increased more than tenfold between 2015 and 2017. The use of immune-checkpoint-inhibitors — which account for 81% of currently FDA approved immunotherapies — increased more than twentyfold by 2024, according to the Cancer Research Institute.
Though quickly becoming a cornerstone of cancer care, the widespread acceptance and enthusiasm behind immunotherapy is relatively new.
“There was a time when immunotherapy was considered experimental and applicable to a very narrow range of tumor types. We have now pivoted to approaches where immunotherapy is front and center,” Julian Kim, MD, president of Greenville, S.C.-based Prisma Health Cancer Institute, told Becker’s. “We are still in early stages of understanding the power of the immune system to treat and prevent cancer.”
