Welcome back to Navigation Refresh, a recurring, informative feature for novice and seasoned patient navigators alike. In this issue, we cover the role of patient navigators in immuno-oncology.
What Is Immuno-Oncology?
Immunotherapy is a newer kind of cancer treatment that helps a patient’s immune system fight cancer by stimulating the immune system to work harder and smarter to attack cancer cells.1,2 Immunotherapies for oncology include cancer vaccines, oncolytic virus therapy, checkpoint inhibitors, adoptive cell therapies, cytokines, monoclonal antibodies, bispecific antibodies, and antibody drug conjugates (Table).3-5 Immunotherapy can be highly personalized, reducing side effects typical of chemotherapy and radiation therapy; however, immunotherapy comes with its own side effects (Box).6
Table. Types of Immuno-Oncology and How They Work3-5
(Scroll to see full table.)
figure {border:none!important;} table, th, td { border: 1px solid #fff!important; border-collapse: collapse!important;} th {background-color:#d2fd79!important;text-align:center!important;} td, th {padding:10px!important;horizontal-align:center;} td {vertical-align:center!important;} tr:nth-child(2n) td {background-color:#dfe1df!important;} tr:nth-child(odd) td {background-color:#fffef8!important;}| Types of Therapy | Definition | How They Work | Examples |
|---|---|---|---|
| Adjuvants | Substances that enhance or modify the immune response to an antigen | Reduce the amount of active ingredient needed in a medicine | BCG bacterial treatment for bladder cancer CpG oligodeoxynucleotides for B-cell lymphoma |
| Agonists | A substance that initiates a physiological response when combined with a receptor | Triggers killer T cells to activate | CD27 agonist for leukemia and lymphoma |
| Adoptive cell therapy or CAR therapy | Patient immune cells are isolated, expanded or modified, and reintroduced to the patient to boost cancer-fighting ability | Activates patient’s immune response | CAR T-cell therapy targeting CD19 protein for B-cell lymphoma |
| Antibody-drug conjugates | Targeted therapy that combines a monoclonal antibody with a cytotoxic drug | Binds to cancer cells to deliver a toxic drug to the tumor | NILK-2301 for colorectal cancer |
| Bispecific antibodies | Antibodies with 2 different antigen binding sites in 1 molecule to link immune cells to tumor cells | Enhances immune response to promote cancer cell death | Cadonilimab for cervical, gastric, and liver cancer |
| Cancer vaccines | There are preventive, therapeutic, and personalized cancer vaccines that are designed to stimulate the immune system and/or kill cancer cells | Preventive vaccines prevent viral infections that cause or contribute to cancer Therapeutic vaccines boost the patient’s immune response Personalized vaccines target antigens present on cancer cells to avoid healthy tissue |
HPV and HBV vaccines
BCG vaccine for early-stage bladder cancer mRNA vaccines |
| Checkpoint inhibitors | Proteins that come from T cells and activate an immune response by targeting checkpoints or regulators of the immune system | Blocks immune checkpoints to allow T cells to attack cancer cells | Ipilimumab for metastatic melanoma |
| Cytokines | Proteins made by white blood cells that mount a coordinated response to a target antigen to affect cell growth, survival, metastasis, and inflammation | Directly activate immune cells to fight cancer | Interleukin-15 (combined with nivolumab) for lung cancer |
| Monoclonal antibody | Laboratory-created, bivalent proteins that mimic human antibodies and bind to a target antigen on the cancer cell | Targets immune checkpoints | Rituximab for leukemia |
| Oncolytic virus therapy | Involves injecting a genetically modified virus into a tumor to destroy cancer cells | Infects and destroys cancer cells | Pexa-Vec for liver cancer |
Abbreviations: BCG, bacillus Calmette-Guérin; HBV, hepatitis B virus; HPV, human papillomavirus.
Box. Side Effects of Immuno-Oncology Treatment6
- Blood pressure changes
- Chills
- Colitis
- Congestion
- Fatigue
- Fever
- Headache
- Heart palpitations
- Itchiness
- Nausea
- Pain
- Pneumonitis
- Organ inflammation
- Rash
- Soreness
- Swelling
- Weight gain
Role of Patient Navigator in Immuno-Oncology
Regis outlined 4 major roles of a patient navigator in immuno-oncology. First, patient navigators need a basic understanding of immuno-oncology. While navigators do not have to memorize all of the immunotherapy options, understanding that side effects are different for immunotherapy is important. Second, patient navigators can work with oncologists to educate patients about immunotherapy treatments if the patient is a candidate. Third, immunotherapies are expensive. With out-of-pocket costs in the tens of thousands, navigators can play a key role in linking patients to financial specialists and/or ensuring that costs of care are discussed prior to treatment. Depending on the scope of practice of the navigator, they may provide basic financial counseling to the patient. Finally, given the heterogeneity of side effects resulting from immunotherapies, navigators can help coordinate care with specialty care providers, such as dermatologists, gastroenterologists, and pulmonologists.7
Alignment With PONT Standards
This edition of Navigation Refresh aligns with Standard 3 (Knowledge), Standard 5 (Interdisciplinary and Interorganizational Collaboration), and Standard 12 (Treatment, Care Planning and Intervention) of the Professional Oncology Navigation Task Force (PONT).8
References
- GW Cancer Center. (PI: Pratt-Chapman). GW Oncology Patient Navigator Training: The Fundamentals. 2025. https://bit.ly/PNTraining
- GW Cancer Center. (PI: Pratt-Chapman). GW Oncology Patient Navigator Training 2025 Guide. 2025. https://bit.ly/PN-Guide2025
- Zhang M, Liu C, Tu J, et al. Advances in cancer immunotherapy: historical perspectives, current developments, and future directions. Mol Cancer. 2025;24:136.
- National Cancer Institute. Immunotherapy to Treat Cancer. 2019. Accessed July 3, 2025. www.cancer.gov/about-cancer/treatment/types/immunotherapy#which-cancers-are-treated-with-immunotherapy
- National Cancer Institute. Targeted Therapy to Treat Cancer. 2022. Accessed July 3, 2025. www.cancer.gov/about-cancer/treatment/types/targeted-therapies
- National Cancer Institute. Immunotherapy Side Effects. 2023. Accessed July 3, 2025. www.cancer.gov/about-cancer/treatment/types/immunotherapy/side-effects
- Regis SM. Patient navigation in immuno-oncology. Am J Manag Care. 2017;23:SP46-SP47.
- Franklin E, Burke S, Dean M et al. Oncology Navigation Standards of Professional Practice. Journal of Oncology Navigation & Survivorship. 2022:13:74-85.
