Targeted and immunotherapy treatment (Targeted anti-cancer therapy and immunotherapy)
Newer cancer medicines that either block a specific feature inside cancer cells or help the immune system attack them, used in many blood cancers.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Targeted therapy blocks a specific feature of the cancer; immunotherapy helps your immune system attack it.
- They only work if the cancer has the right target or responds to the immune approach, so testing matters and they do not suit everyone.
- Side effects are real and different from chemotherapy; immunotherapy can make the immune system attack healthy organs, sometimes seriously.
- Ask your consultant the aim of treatment, how it will be monitored, and which side effects need urgent help.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can control or shrink many blood cancers, sometimes for long periods
When tests show the cancer does not have the target the drug acts on, so it is unlikely to work.
Staff watch for infusion or early reactions. With tablets, the first weeks help show how you tolerate the drug. Report new symptoms rather than waiting.
Clear, written information on your drug's side effects and immune warning signs.
Staff watch for infusion or early reactions. With tablets, the first weeks help show how you tolerate the drug...
Regular blood tests and reviews check the drug is working and look for side effects. Doses may be adjusted, paused...
Immunotherapy side effects can come on at any time. They are usually manageable if caught early, sometimes with...
Scans, blood tests or marrow tests at set points show how the cancer is responding. The plan can change based on...
What it is
Targeted therapy and immunotherapy are newer types of cancer medicine. Targeted therapy works by blocking a specific feature that a cancer needs to grow — for example a faulty protein or signal inside the cancer cells. Immunotherapy works differently, by helping your own immune system find and attack the cancer.
In blood cancers these treatments are now very important. Examples include tyrosine kinase inhibitors (TKIs) such as those used in chronic myeloid leukaemia, antibody treatments such as rituximab in lymphoma, and advanced immune treatments such as CAR-T cell therapy for some leukaemias and lymphomas. Some are tablets taken at home; others are given as injections or drips in hospital.
Unlike older chemotherapy, which affects many fast-dividing cells, these drugs are more selective — but they still have real side effects, and immunotherapy can cause the immune system to attack healthy organs. They only work if the cancer has the right target or responds to the immune approach, so tests on your blood or marrow help decide whether they suit you.
These treatments are used as part of a wider plan agreed by a multidisciplinary team (MDT), often alongside or after chemotherapy, and they do not come with a guarantee of cure.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Targeted therapy and immunotherapy compared with chemotherapy
| Approach | How it works | Key point |
|---|---|---|
| Targeted therapy | Blocks a specific feature of the cancer | Needs the right target to be present |
| Immunotherapy | Helps the immune system attack the cancer | Can cause immune-related side effects |
| Chemotherapy | Kills or slows fast-dividing cells generally | Broad effect, more typical chemo side effects |
| Often combined | Used together or in sequence | MDT chooses based on your cancer and test results |
These approaches are frequently combined. The right choice depends on the specific blood cancer, its genetics and your overall health.
Preparing for your treatment
- Make sure you understand whether the aim is to cure, control or relieve symptoms, and how long treatment is likely to last.
- Ask whether tests on your blood or marrow have confirmed the cancer has the right target for the drug.
- Tell your team about all your medicines and supplements, as some interact with targeted drugs.
- Mention any autoimmune conditions, past organ problems, infections (including hepatitis), and whether you could be pregnant or breastfeeding.
- You will usually have baseline blood tests and sometimes heart, lung or organ checks before starting.
- For some treatments, especially CAR-T, ask about the hospital stay, monitoring and possible early reactions.
- Make sure you are given written information on your drug's specific side effects and a 24-hour emergency contact.
- Ask about fertility if it matters to you, as some treatments may affect it.
What happens
How treatment is given depends on the drug. Tablets such as TKIs are taken at home, usually daily, with regular blood tests and clinic reviews to check they are working and to watch for side effects.
Antibody treatments and some immunotherapies are given as a drip through a cannula or line. The first dose is often given slowly while staff watch for an infusion reaction. Later doses may be quicker if the first was well tolerated.
Immune checkpoint inhibitors are given as drips at set intervals. Because they can make the immune system attack healthy organs, you will be monitored for symptoms such as diarrhoea, breathlessness, rashes or hormone changes between treatments.
CAR-T therapy is a longer process: your immune cells are collected, sent to a laboratory to be modified over a few weeks, and then given back, usually with a hospital stay so the team can monitor for early reactions. This is delivered only in specialist centres.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- When tests show the cancer does not have the target the drug acts on, so it is unlikely to work.
- When an autoimmune condition or organ problem makes immunotherapy too risky without specialist review.
- When the cancer type or stage is better treated another way, such as chemotherapy, transplant or supportive care.
- When a person decides, after honest discussion, that the likely benefit does not justify the risks for them.
- When a private setting cannot provide the monitoring or emergency support a treatment needs, such as CAR-T.
Delay or rearrange if…
- You have an active infection or are unwell.
- Baseline tests, organ-function checks or target testing are not yet complete.
- An old infection such as hepatitis needs checking or treating first with certain antibody drugs.
- Your blood counts are too low to start safely.
- There is a chance of pregnancy that needs to be confirmed first.
Alternatives to discuss
- Chemotherapy, where it is more appropriate for the cancer.
- A stem cell transplant, radiotherapy or surgery as part of the plan, depending on the cancer.
- Active monitoring (watch and wait) for some slow-growing blood cancers.
- Best supportive and palliative care focused on symptoms and quality of life.
- A clinical trial of a newer treatment where one is suitable and available.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Can control or shrink many blood cancers, sometimes for long periods
- More selective than older chemotherapy for some cancers, with a different side-effect pattern
- Some can be taken as tablets at home, fitting around daily life
- Immunotherapy can produce durable responses in some people who have run out of other options
- Can be combined with chemotherapy or other treatments to improve results
Risks & complications
- Tiredness during treatment
- Drug-specific effects such as rashes, diarrhoea, nausea, or aches and cramps
- Lower blood counts with some drugs, raising the risk of infection
- Infusion reactions during or soon after a drip, which staff watch for
- Flu-like symptoms after some treatments
- Immune-related side effects where the immune system attacks healthy organs (gut, liver, lungs, skin, hormone glands)
- Heart, lung, liver or kidney effects with certain drugs
- Reactivation of old infections, such as hepatitis, with some antibody treatments
- Thyroid or other hormone changes with immunotherapy
- Severe infusion or allergic reactions
- Severe immune reactions affecting major organs that need urgent treatment, sometimes with steroids
- Cytokine release syndrome and nervous-system effects with CAR-T therapy, which specialist teams monitor closely
- Serious infection if blood counts or the immune system are significantly affected
The side effects depend heavily on the specific drug, so general descriptions are only a starting point — ask for written information about your treatment. With immunotherapy in particular, new symptoms such as ongoing diarrhoea, breathlessness, a marked rash, or feeling very unwell can be immune-related and need prompt medical advice, not waiting to see if they pass. CAR-T therapy has its own early risks and is given in specialist centres with intensive monitoring.
Published figures to discuss
Benefit and side-effect rates vary widely between different drugs, the cancers they treat, and individuals, so a figure from one study often does not apply to another treatment. Immune-related side effects, in particular, vary in how often and how severely they occur. Rather than relying on a single percentage, the key is understanding which side effects matter for your specific drug and acting early if they appear. Ask your consultant for figures relevant to your treatment.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Immune-related side effects | Drug-dependent and can affect any organ | Diarrhoea, breathlessness, rash, hepatitis, endocrine problems or severe fatigue on immunotherapy need urgent reporting. | Guide sourcesClinical context |
| Target not present or resistance develops | Cancer/genetics-dependent | Molecular testing guides treatment, and cancers can become resistant over time. | Guide sourcesClinical context |
| Infection or low blood counts | Treatment-dependent | Many targeted blood-cancer therapies affect immunity and require monitoring. | Blood Cancer UK — CAR-T cell therapy on the NHSbloodcancer.org.ukSource-linked context |
| Interactions with other medicines | Common with oral targeted agents | Antibiotics, antifungals, anticoagulants, PPIs and supplements can alter levels of some treatments. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
These treatments are usually given over weeks, months or longer rather than as a one-off, so 'afterwards' means how you feel during treatment and once it finishes. Many people continue much of their normal life, but monitoring for side effects, especially immune-related ones, continues throughout and sometimes after.
- Tiredness that comes and goes during treatment
- Mild, drug-specific effects such as a rash, loose stools or aches that are monitored
- Continuing much of normal daily life with some treatments
- Needing regular blood tests and clinic visits to stay safe
- Some ups and downs in mood during a demanding treatment
Aftercare
- Carry an alert card or treatment record showing which drug you are on, especially for immunotherapy.
- Report new or ongoing symptoms early, such as diarrhoea, breathlessness, a marked rash or feeling very unwell.
- Take tablet treatments exactly as prescribed and do not stop suddenly without advice.
- Avoid starting new medicines or supplements without checking, because of interactions.
- Keep all blood tests and monitoring appointments so the treatment stays safe and effective.
- Use reliable contraception if pregnancy is possible, as some treatments can harm a developing baby.
- Tell any other healthcare professional you see that you are on targeted or immune treatment.
- Have your 24-hour emergency contact number to hand.
- An alert card or treatment record for your specific drug
- Written information on your drug's side effects and immune warning signs
- A 24-hour emergency contact number saved
- A list of all your current medicines and supplements
- A clear monitoring and blood-test schedule
- Contraception arranged if pregnancy is possible
- Knowing who to contact if new symptoms appear
⚠ Get urgent help if…
- A high temperature, or feeling hot, cold or shivery — possible infection needing urgent help, especially if your blood counts are low
- Severe or ongoing diarrhoea, or blood in your stools (a possible immune side effect)
- New or worsening breathlessness or a persistent cough
- Severe rash, blistering, or yellowing of the skin or eyes
- Severe tummy pain, persistent vomiting, or feeling very unwell
- Confusion, severe headache, slurred speech or fits — call 999 (important after CAR-T therapy)
- Swelling, wheeze or difficulty breathing during or soon after a drip (possible reaction)
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result means the cancer shrinks, becomes stable, or its activity falls, and this is judged over weeks to months with blood tests, scans or marrow tests. For some treatments, such as TKIs in chronic myeloid leukaemia, response is tracked with specific blood tests over time. These treatments can work very well for some people, but they do not work for everyone and do not guarantee a cure.
Response depends heavily on the type of blood cancer, its genetics and whether the right target is present, so be cautious about figures you read online. Ask your own consultant what response they are aiming for, how it will be measured, and what the options are if the treatment stops working.
Some targeted treatments are taken long term to keep a cancer controlled, and stopping is only considered carefully under specialist guidance. Immunotherapy responses can sometimes last well beyond the treatment course, but this varies. Cancers can also become resistant over time, so ongoing monitoring is important, and your team can explain what to expect for your specific situation.
Related tests, treatments or support
Targeted therapy and immunotherapy are often combined with chemotherapy, or given in sequence with it, and sometimes alongside radiotherapy or a stem cell transplant. Supportive care — infection prevention, vaccinations as advised, and sometimes transfusions or growth-factor injections — is also part of the plan. Your MDT decides the combination based on your diagnosis and test results.
Follow-up & long-term care
You will have regular reviews and blood tests during treatment, and scans or marrow tests at set points to check response. Monitoring for immune-related side effects continues throughout and sometimes after treatment. You should always have a clear route to contact the team urgently if new symptoms appear between appointments.
- Regular blood tests and monitoring during and sometimes after treatment
- Ongoing checks for immune-related side effects, including hormone levels with some drugs
- Long-term tablet treatment with monitoring for some conditions, such as TKIs
- Infection prevention and keeping vaccinations up to date as advised
- Long-term follow-up to watch for the cancer returning or becoming resistant
Repeat, follow-on and what comes next
- Doses may be reduced, paused or switched if side effects, including immune-related ones, develop.
- Cancers can become resistant to a targeted drug over time, so treatment may need to change.
- If one treatment stops working, the team may move to a different drug, combination or approach.
- Treatment plans are reviewed at set points based on response, tolerance and your wishes.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear, written information on your drug's side effects and immune warning signs.
- A 24-hour emergency contact and a hospital that can assess and admit you.
- Regular monitoring tests, with doses adjusted or treatment switched as needed.
- An alert card or treatment record so other clinicians know what you are on.
- Coordination between private and NHS care, including specialist centres for treatments such as CAR-T.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The specific drug used and whether it is taken as tablets, injections or drips
- How long treatment is expected to continue
- Whether treatment is outpatient, day case, or needs a hospital stay (as with CAR-T)
- Baseline and ongoing monitoring tests, including blood, heart, lung or organ checks
- Scans and marrow tests to assess response
- Consultant and specialist nurse time, and 24-hour emergency cover
- Management of side effects, including immune-related complications
- The consultant haematologist or oncologist fee and who leads your care
- Drug costs and the expected duration of treatment
- Facility, day-unit or inpatient fees, including any line insertion
- Cost of monitoring blood tests, scans and marrow tests
- What 24-hour emergency cover is provided and where you would be admitted
- How treatment of side effects, including immune-related ones, is covered
- What happens, and what it costs, if the treatment is changed or extended
On the NHS? Many targeted and immune treatments are available on the NHS when approved for a particular condition; private care is used mainly for speed of access, choice of consultant or a second opinion, usually alongside NHS services.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not confirming the cancer has the right target before starting a targeted drug.
- Immune-related side effects not being clearly explained, so warning signs are missed.
- Side effects described only generally rather than for your specific drug.
- Fertility risks not discussed before starting where they apply.
- No clear plan for monitoring, emergencies or how private and NHS care join up.
Marketing red flags
- Promising a cure or guaranteed response from a targeted or immune treatment.
- Offering expensive treatment without confirming the cancer has the right target.
- Downplaying immune-related side effects, which can be serious.
- Pressure to start quickly without MDT discussion or a second opinion.
- No clear arrangements for monitoring, emergency cover or working with the NHS.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Has testing confirmed my cancer has the right target for this treatment?
- Is the aim to cure, control or relieve symptoms, and how will you measure response?
- What are the main side effects of my specific drug, and which need urgent help?
- With immunotherapy, what immune-related symptoms should prompt me to call you?
- How long am I likely to be on treatment, and what happens if it stops working?
- Is this available on the NHS for my condition, and how will my care be coordinated?
- Could this treatment affect my fertility?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
How is this different from chemotherapy?
Will it work for me?
Are these treatments available on the NHS?
What are immune-related side effects?
What is CAR-T therapy?
Can I take these as tablets at home?
Could it affect my fertility?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Blood Cancer UK — Blood cancer treatment types Cancer Research UK — Targeted cancer drugs Cancer Research UK — Immunotherapy Macmillan — Targeted therapy and immunotherapy Blood Cancer UK — CAR-T cell therapy on the NHS NICE — cancer guidance and technology appraisals (targeted and immune therapies) British Society for Haematology — treatment guidelines
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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