Advantages and Disadvantages of Immunotherapy

Among the advantages of immunotherapy are the following:

  • Uses the body’s own immune system
  • Fewer side effects than chemotherapy drugs and radiation therapy
  • It is tolerated well as an adjuvant therapy and can be given along with chemotherapy
  • Decreases the risk of recurrence by 50%
  • Can improve long-term survival by 30%[1]

What are the Disadvantages of Immunotherapy?

The disadvantages of immunotherapy have to do with their side effects as listed before:

  • Fever
  • Chills
  • Nausea
  • Diarrhea
  • Vomiting
  • Generalized pain – particularly in the bones, joints and legs
  • Weakness or Fatigue
  • Headaches
  • Rashes

What are the More Serious Risks?

The most serious potential side effects that may lead to permanent health-related issues are cardiotoxicity and pulmonary toxicity.

  • Cardiotoxicity: This means that the drug can damage the heart. Specifically, it damages the ventricles of the heart, weakening the muscle. This means that the heart cannot pump blood to the body effectively, causing damage to other organs as well. This is called heart failure, or specifically congestive heart failure, and the heart will dilate over time to compensate. Patients with the highest risk of developing cardiotoxicity with this drug are elderly patients and those with a previous history of heart disease or diabetes. The use of trastuzumab in conjunction with anthracycline-type chemotherapy also increases risk of cardiotoxicity, as they are both individually associated with cardiotoxicity.[2]
  • Pulmonary toxicity: This describes the damage that is caused to the lungs as a result of this drug. Symptoms of pulmonary toxicity are shortness of breath, coughing and low blood oxygen levels. It may even cause fluid to build up around the lungs, called pulmonary edema. Over time, this damage can be so severe that it causes respiratory failure where a patient is dependent on a ventilator, ultimately ending in death.

How to Manage the Risks

Since trastuzumab does have serious potential side effects, particularly in the elderly, it is important to understand how to prevent them. The following are some helpful tips:

  • Talk to your doctor about your entire medical history. This includes conditions such as allergies, asthma, heart murmurs and any medical conditions that are being treated with medicine.
  • Your doctor will likely perform a few tests on your heart and lungs prior to beginning therapy, to see what the baseline function is, making monitoring more effective.
  • Your heart and lungs will be monitored at least once every three months while you are taking the drug to ensure that they are not being damaged.[3]


You and your doctor will determine if the benefits of taking trastuzumab outweigh the risks in your particular case.

1 Braga, S; dal (Braga, dal Lago and Bernard) Lago, L; Bernard, C; Cardoso, F; Piccart, M (2006). Use of Trastuzumab for the Treatment of Early Stage Breast Cancer. Expert Review of Anticancer Therapy, 6(8): 1153-64.

2 Tan-Chiu, E; Yothers, G; Romond, E; Geyer, Jr, EC;  Ewer, M;  Keefe, D; Shannon, RP; Swain, SM; Brown, A; Fehrenbacher, L; Vogel, VG; Seay, TE; Rastogi, P; Mamounas, EP; Wolmark, N; and Bryant, J (2005). Assessment of Cardiac Dysfunction in a Randomized Trial Comparing Doxorubicin and Cyclophosphamide followed by Paclitaxel, With Or Without Trastuzumab As Adjuvant Therapy in Node-Positive, Human Epidermal Growth Factor Receptor 2-Overexpressing Breast Cancer: NSABP B-31. J Clinical Oncology, 23:7811-7819.

3 McKeage, K; and Lyseng-Williamson, KA (2008). Trastuzumab: A Pharmacoeconomic Review of its Use in Early Breast Cancer. PharmacoEconomics, 26(8):699-719.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.