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When Is Immunotherapy Recommended? A Medical Oncologist Explains

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By Author: Dr Viraj Lavingia
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If you're consulting a medical oncologist in India, understanding what immunotherapy actually is and when it's genuinely the right choice can help you have a much more informed conversation during your treatment planning.
What Immunotherapy Actually Does
Unlike chemotherapy, which directly attacks fast-growing cells, immunotherapy works differently. It essentially trains and boosts your own immune system to recognize and fight cancer cells on its own.
It helps the immune system identify cancer cells that were previously going undetected.
It can work alongside chemotherapy, or sometimes on its own, depending on the cancer type.
It doesn't work the same way for every cancer effectiveness varies a lot based on the tumor's specific biology.
This last point is important, because it's exactly why immunotherapy isn't automatically the first choice for everyone.
When Doctors Consider Immunotherapy
A cancer specialist doesn't simply choose immunotherapy because it's newer or sounds promising. There are specific situations where it tends to make real clinical sense.
When specific biomarkers ...
... are present – certain tumors carry genetic or molecular markers, like MSI-high or dMMR status, which make them more likely to respond well to immunotherapy.
When standard treatments haven't worked as expected – in some cases, immunotherapy becomes an option after chemotherapy alone hasn't achieved the desired response.
In certain advanced-stage cases particularly where the cancer has spread and doctors are looking for treatment approaches beyond conventional chemotherapy.
Dr Viraj Lavingia, a medical oncologist based in Ahmedabad, often explains to patients that biomarker testing is what really determines eligibility; it's not a treatment offered simply based on stage or symptoms alone.
Why Testing Comes Before Treatment
Before immunotherapy is even considered, specific lab tests need to confirm whether a tumor is likely to respond to it.
Biomarker testing helps identify whether the cancer has features that make immunotherapy effective.
Without this testing, doctors are essentially guessing, which isn't how modern cancer care works.
Results from this testing directly shape whether immunotherapy becomes part of the treatment plan, or whether other approaches are more suitable.
This is one of the biggest misconceptions patients have that immunotherapy is a general upgrade available to everyone. In reality, it's a precise, test-driven decision.
What Makes Immunotherapy Different From Chemotherapy
Patients often want to know how the experience compares, especially when it comes to side effects and treatment routine.
Immunotherapy is usually given through IV infusions, often on a different schedule than chemotherapy.
Side effects tend to be different too; rather than the classic chemotherapy side effects, immunotherapy can sometimes cause immune-related reactions, which require their own kind of monitoring.
Some patients tolerate immunotherapy more comfortably than chemotherapy, though this varies significantly from person to person.
It's not about one being universally "easier" than the other, it's about which approach fits the specific cancer and the specific patient.
Setting Realistic Expectations
It's worth being upfront here: immunotherapy isn't a guaranteed solution, and it isn't right for every patient or every cancer type. Response rates vary, and ongoing monitoring is essential to see how well it's working.
Patients researching cancer specialists in Ahmedabad often appreciate that Dr Viraj Lavingia takes the time to explain both the potential benefits and the realistic limitations of immunotherapy, rather than presenting it as a one-size-fits-all breakthrough.
The Bottom Line
Immunotherapy represents a genuinely important advancement in cancer treatment, but it's not automatically the right path for everyone. It comes down to tumor biology, biomarker testing, and a careful evaluation by your medical oncologist. If you're curious whether it applies to your specific situation, that conversation backed by proper testing is exactly where it should start.

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