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Immunotherapy enhances your immune system’s ability to target cancer cells. Chemotherapy acts directly on cancer cells to keep them from replicating.

Immunotherapy and chemotherapy are two commonly used cancer treatments. Both types of therapy involve the use of drugs to stop the growth of cancer cells. Although they have the same goal, they accomplish it differently.

Your healthcare team may recommend both treatments at the same time or in addition to other cancer treatments, such as radiation therapy or surgery.

Keep reading as we examine the similarities and differences between immunotherapy and chemotherapy.

Cancer cells are abnormal cells that replicate uncontrollably. Typically, your immune system destroys abnormal cells. However, cancer cells may be able to hide from your immune system by:

  • having genetic changes that reduce their visibility
  • containing proteins that turn off your immune cells
  • changing cells around the tumor so that they interfere with your immune response

Immunotherapy helps your immune system recognize and destroy cancer cells

Immunotherapy drugs help your immune system recognize cancer and destroy it. The ultimate goal of immunotherapy is to create a group of immune cells (usually T cells) that specifically target cancer. T cells are a special type of white blood cell that attacks foreign invaders.

Immunotherapy is a growing area of research. Many scientists are optimistic it could lead to breakthroughs in cancer treatment.

How immunotherapy drugs are delivered

You take immune therapy drugs through an IV. Immunotherapy is used to treat a wide range of cancers but isn’t yet as widely used as chemotherapy, radiation therapy, and surgery.

Types of immunotherapy drugs

Medical professionals classify immunotherapy drugs based on how they target your immune system.

  • Immune checkpoint inhibitors: block immune checkpoints, part of your natural immune response that keep your immune system from being too aggressive
  • T-cell transfer therapy: enhances the ability of your T cells to recognize and attack cancer cells
  • Monoclonal antibodies: proteins that bind to cancer cells and mark them for your immune system
  • Treatment vaccines: help boost your immune system’s response to cancer cells
  • Immune system modulators: enhance your immune system or a specific part of your immune system

Chemotherapy is a chemical drug therapy that helps keep cancer cells from replicating. Scientists developed the first chemotherapy drugs around the 1940s.

Chemotherapy helps stop cancer cells from replicating

Chemotherapy helps treat cancer by:

  • decreasing the number of cancer cells in your body
  • reducing the chances of the cancer spreading or returning
  • shrinking tumors
  • reducing your symptoms

How chemotherapy is delivered

Chemotherapy drugs can be administered in several ways, such as:

Doctors use chemotherapy to target a wide range of cancer types. However, the chemicals in chemotherapy drugs can also damage healthy cells, which leads to common side effects like hair loss and nausea.

Types of chemotherapy drugs

There are more than 100 chemotherapy drugs doctors can use to treat cancer. The type of drug your doctor chooses will depend on such factors as:

  • your age and health
  • the type of cancer you have
  • how far it’s progressed
  • if you’ve previously received chemotherapy treatment

Each category of chemotherapy drug has its own mode of action, and some drugs work better for certain cancers.

Immunotherapy and chemotherapy both have the potential to be effective cancer treatments. One isn’t necessarily better than the other.

Experts traditionally consider chemo to be the most effective treatment broadly. However, the treatment that works best for you will depend on many factors, such as the biology profile, behavior, and location of the cancer.

Speed of action

When you first start treatment, chemotherapy has the potential to have an almost immediate effect on shrinking a tumor. Immunotherapy often takes longer to take effect.

Duration of action

Chemotherapy stops working once you stop receiving the drugs. Immunotherapy can potentially stimulate your immune system to continue fighting cancer even after you stop treatment.

What is chemo-immunotherapy?

Doctors often prescribe multiple types of cancer treatment. Recent research suggests that a combination of chemotherapy and immunotherapy may be an effective therapy for some difficult-to-treat cancers.

Both types of treatment can potentially cause mild and serious side effects.

While chemo targets rapidly dividing cancer cells, it can also damage other cells in your body that divide rapidly, such as hair, skin, blood, and intestinal cells.

Damage to these cells can lead to many potential side effects, such as:

Many immunotherapy side effects result from the overactivation of your immune system. Side effects can include

  • skin rash
  • cough
  • shortness of breath
  • abdominal discomfort
  • diarrhea

In more serious cases, it can cause your immune system to attack your organs.

The cost of chemotherapy and immunotherapy can vary widely based on factors such as how long you need treatment, what type of cancer you have, and how far your cancer has spread.

A 2024 systematic review found that immune checkpoint inhibitors, a type of immunotherapy, were usually more cost-effective than chemotherapy treatment options for advanced non-small cell lung cancer.

Although immunotherapy is a newer class of treatment, insurance programs, including Medicare, will often cover immunotherapy drugs. Check with your insurance provider to learn more about your out-of-pocket costs for each treatment type.

Chemotherapy and immunotherapy are two types of drug therapies doctors use to treat cancer. Immunotherapy aims to boost the function of the immune system so that it can destroy cancer cells, while chemotherapy directly inhibits cancer cells’ ability to replicate.

Both types of treatment can be effective at treating cancer. They may be used together or combined with other cancer treatments.

Discuss treatment options with your doctor to learn the best options for your situation. They can explain the advantages and disadvantages of each treatment and how best to integrate them into a holistic treatment plan.