Colorectal cancer (CRC) is a significant public health concern in Germany, ranking among the most commonly diagnosed cancers. In 2022, approximately 24,650 women and 29,960 men were newly diagnosed with CRC [1]. The incidence rates are notably higher in individuals over the age of 55, with the majority of cases originating in the colon rather than the rectum.
Despite the improvements in diagnosis and treatment, CRC remains a leading cause of cancer-related deaths. The 5-year relative survival rate varies significantly by stage, ranging from about 90% for stage I to approximately 12% for stage IV. This highlights the urgent need for effective treatment options, particularly for patients with advanced-stage disease.
In response to this need, Germany has become a leader in the field of cancer immunotherapy. German oncology clinics have reported remission rates exceeding 90% in early-stage colon cancer and around 80% in advanced cases when dendritic cell therapy is integrated into a multidisciplinary treatment plan.
Role of immunotherapy for colon cancer
The optimal time for the administration of cancer immunotherapy is after surgical removal of the colorectal tumor and, if possible, the largest metastases. However, immunotherapy is also highly suitable in the other therapeutic schemes when surgery is not an option.
The main candidates for immunotherapy for sigmoid colon cancer treatment are patients with advanced high-degree microsatellite instability (MSI). MSI is identified through the genetic analysis of resected tumor cells from the digestive system. In the human genome, there are 4 genes that are responsible for correcting DNA errors during its copying. This is an obligatory stage of the reproduction of all cells. If one or more of these genes is damaged, then defective DNA accumulates in cancer cells – in medicine, this is called microsatellite instability.
High-degree microsatellite instability is detected in 15% of patients with advanced colorectal cancer. Such a clinical situation has certain peculiarities:
- Patients treated have a low risk of metastasizing (at stage 4, high-degree MSI is detected in no more than 3-4% of patients with advanced cancer).
- Patients with advanced cancer will benefit from cancer immunotherapy, in particular with the use of PD-1 receptor inhibitors.
- Patients should be screened for Lynch syndrome – a hereditary malignant lesion of the intestine, in which concomitant tumor cells of the stomach, urinary tract, ovaries, brain, and other organs are often detected. In this case, healthcare professionals may additionally administer esophageal cancer immunotherapy, stomach cancer immunotherapy, etc.
Assessment of the microsatellite instability degree also allows doctors to assess the potential sensitivity of the tumor cells to chemotherapy drugs. This is important because chemotherapy and cancer immunotherapy are often given as a combination treatment.
According to recent research, it makes sense to start immunotherapy treatments earlier and administer them even in patients with advanced cancer stages 1-3. This allows for achieving remission faster and increases life expectancy several times. German oncology centers offer innovative cancer immunotherapy for colon cancer treatment, often combining treatment with conventional and alternative methods (e.g., hyperthermia) to enhance targeting of cancer cells and alleviate symptoms such as pain. This comprehensive approach aims to boost the immune response of immune cells and T-cells against cancer cells, while potentially protecting healthy cells and improving patients' quality of life during cancer treatment.
Types of immunotherapy for colon cancer
Colorectal tumor cells successfully avoid attacks of anti-cancer immunity with the help of various mechanisms: by synthesizing immunosuppressive substances, stimulating the development of inflammation, and so on. The task of cancer immunotherapy is to counter these mechanisms and activate the patient's natural immune response and immune system against cancer cells. To achieve this goal, German oncologists use several groups of drugs that enhance the activity of T-cells and other immune cells, aiming to kill cancer cells while preserving healthy cells.
Immune Checkpoint Inhibitors
One of the most important breakthroughs in cancer immunotherapy has been the development of immune checkpoint inhibitors. Normally, the immune system uses checkpoints such as PD-1, PD-L1, and CTLA-4 to prevent T-cells from overreacting and damaging healthy cells. Colon tumor cells, however, exploit these checkpoints by sending "false signals" that deactivate the body’s defenses. Drugs known as checkpoint inhibitors block these signals, allowing T-cells and other cells of the immune system to stay active and continue to attack cancer cells.
For patients with advanced colon cancer, this approach can restart an effective immune response, shrinking tumors and extending survival. In some cases, doctors combine checkpoint inhibitors with chemotherapy or targeted drugs as a combination treatment, making them one of the strongest options in modern cancer treatment.
Cancer Vaccines
Another innovative strategy is the use of cancer vaccines. Unlike traditional vaccines that protect against viruses, these are designed to teach the immune system how to recognize and destroy cancer cells. Peptide vaccines and autologous vaccines introduce tumor antigens that "train" T-cells to identify and eliminate tumor cells. Among them, dendritic cell vaccines hold a special place. Dendritic cells act as teachers of the immune system, showing T-cells which antigens to attack.
Their importance was highlighted by research that earned a Nobel Prize, underlining how crucial these immune cells are in building an anti-cancer defense. In clinical practice, dendritic vaccines are used both for early-stage and patients with advanced colon cancer, boosting the body’s ability to kill cancer cells while protecting healthy cells.
Several other types of colon cancer vaccines are used for the treatment of colorectal cancer:
- Autologous colon cancer vaccines are created from parts of a patient's tumor. The tumor antigens in such a vaccine are excellently visible for anti-cancer immunity, and thus, a powerful immune response is triggered. Unfortunately, these drugs do not work for all people and cause side effects.
- Peptide vaccines are a more specific type of vaccine that targets T-cells with specific tumor markers, such as cancer embryonic antigen (CEA) or beta-hCG.
Prof. Frank Gansauge: How Dendritic Cell Therapy is Transforming Modern Cancer Treatment
Adoptive Cell Therapy
Adoptive cell therapy is considered one of the most personalized immunotherapy treatments available today. In this method, doctors extract T-cells or other cells of the immune system directly from the patient’s tumor or blood. These cells are then either genetically modified or multiplied in the laboratory to make them stronger at detecting and attacking cancer cells. When reintroduced into the body, they act like an army of highly trained soldiers, programmed to find and destroy tumor cells that were previously invisible to the natural immune response.
For patients with advanced colon cancer who no longer respond to standard therapies, adoptive cell therapy can offer a lifeline, harnessing the precision of the body’s own defenses to treat cancer more effectively.
Toll-like Receptor (TLR) Agonists
Toll-like receptors are part of the innate immune system, acting as sensors that recognize dangerous invaders. Unfortunately, many tumor cells manage to hide from these sensors. TLR agonists are drugs that stimulate these receptors, essentially sounding the alarm within the body. Once activated, immune cells release signals that attract T-cells and boost their ability to attack cancer cells. This creates a chain reaction, where the entire immune response becomes more powerful. TLR agonists are often combined with other immunotherapy treatments, enhancing their effect in both early-stage and patients with advanced colon cancer.
Gut Microbiome Correction
In recent years, researchers have discovered that the gut microbiome—the trillions of bacteria living in our intestines—plays a critical role in how well the immune system responds to cancer treatment. A disrupted microbiome can weaken immune response, reduce the efficiency of T-cells, and make it harder to treat cancer. By correcting imbalances in gut flora through diet, probiotics, or fecal microbiota transplantation, doctors can improve the effectiveness of cancer immunotherapy. In practical terms, a healthy microbiome supports stronger immune cells, ensures better targeting of tumor cells, and helps protect healthy cells during therapy. This area of research is still developing, but it shows how even supportive therapies can enhance outcomes for patients with advanced colon cancer.
How is immunotherapy for colon cancer carried out?
Immune checkpoint inhibitors (PD-1/PD-L1 inhibitors, CTLA-4 inhibitors) are given by intravenous injection under medical supervision in a day hospital. The drug is given every 3–6 weeks, depending on the individual's cancer treatment regimen. Immune checkpoint inhibitors are well tolerated, activating the immune system and T-cells, with mild side effects such as fatigue, loss of appetite, nausea, and diarrhea.
Colon cancer vaccines are administered subcutaneously in a day clinic. In the case of dendritic cell vaccines, which stimulate a targeted immune response, the course of cancer immunotherapy typically includes 1 injection that boosts lifelong anticancer immunity. This method helps immune cells recognize and attack cancer cells, while sparing healthy cells. Repeated treatments are also possible when needed.
Adoptive cell therapy requires only a single intervention, which is inpatient colon cancer treatment. Hospital admission is mandatory because patients with advanced disease receive high-dose chemotherapy before the infusion of modified CAR T-cells. The laboratory phase of CAR T-cell production can take up to 3 weeks, so the patient visits the clinic twice: for blood donation and directly for immunotherapy treatments.
Toll-like receptor (TLR) agonists and correction of the intestinal microbiome are currently used in clinical trials, according to approved regimens. These methods strengthen immune response, stimulate immune cells, and may, in the future, become part of combination treatment strategies to treat cancer more effectively.
Benefits of immunotherapy treatments for colon cancer
In countries with developed healthcare systems, cancer immunotherapy is increasingly becoming one of the first-line treatments for colon malignancies, although initially it was used only in patients with advanced cancer (i.e., metastatic and resistant tumor cells). If chemotherapy and targeted therapy fail, the average life expectancy of a person with metastatic colon cancer is 6 months, as uncontrolled growth of cancer cells limits the effect of standard cancer treatment. In countries with poorly developed medicine, tumor resistance to standard chemotherapy means that the possibilities of medical care are exhausted, and doctors proceed to symptomatic and palliative treatment.
Such an indication for cancer immunotherapy was justified: by switching to this type of therapy, doctors could significantly extend the life of patients with advanced colon cancer. For example, after adoptive cell therapy, the average life expectancy of people with metastatic colon cancer increases from 14 to 28 months, as modified T-cells and other immune cells generate a powerful immune response to destroy tumor cells.
The next practical step was the administration of immune checkpoint inhibitors and vaccination for colon cancer treatment at earlier stages of the disease, when other methods of therapy could still be used. The only condition was the preliminary surgical removal of the tumor cells if the doctors considered such an operation possible.
Clinical trials and practical experience demonstrate that after the start of immunotherapy treatments, numerous cytotoxic T-cells appear in the blood of patients with advanced colon cancer. These are immune cells that actively kill cancer cells in the primary intestinal tumor and its metastases. The progression of cancer slows down, leading in some cases to remission even in advanced stages.
| Cancer stage | Response to standard treatment protocol | Response to standard treatment protocol + Immunotherapy |
|---|---|---|
| Stage 3 | 50% | 20% |
| Stage 4 | 70% | 50% |
*According to Booking Health data
A Medical Journey: Every Step of the Way With Booking Health
Finding the best treatment strategy for your clinical situation is a challenging task. Being already exhausted from multiple treatment sessions, having consulted numerous specialists, and having tried various therapeutic interventions, you may be lost in all the information given by the doctors. In such a situation, it is easy to choose a first-hand option or to follow standardized therapeutic protocols with a long list of adverse effects instead of selecting highly specialized innovative treatment options.
To make an informed choice and get a personalized cancer management plan, which will be tailored to your specific clinical situation, consult medical experts at Booking Health. Being at the forefront of offering the latest medical innovations for already 12 years, Booking Health possesses solid expertise in creating complex management programs in each individual case. As a reputable company, Booking Health offers personalized treatment plans for colorectal cancer with direct clinic booking and full support at every stage, from organizational processes to assistance during treatment. We provide:
- Assessment and analysis of medical reports
- Development of the medical care program
- Selection of a suitable treatment location
- Preparation of medical documents and forwarding to a suitable clinic
- Preparatory consultations with clinicians for the development of medical care programs
- Expert advice during the hospital stay
- Follow-up care after the patient returns to their native country after completing the medical care program
- Taking care of formalities as part of the preparation for the medical care program
- Coordination and organization of the patient's stay in a foreign country
- Assistance with visas and tickets
- A personal coordinator and interpreter with 24/7 support
- Transparent budgeting with no hidden costs
Health is an invaluable aspect of our lives. Delegating management of something so fragile yet precious should be done only to experts with proven experience and a reputation. Booking Health is a trustworthy partner who assists you in pursuing stronger health and a better quality of life. Contact our medical consultant to learn more about the possibilities of personalized treatment with innovative methods for colorectal cancer with leading specialists in this field.
Immunotherapy Journey: Dendritic Cell Treatment with Booking Health
Frequently Asked Questions of Our Patients About Immunotherapy for Colon Cancer in Germany
Get a ConsultationImmunotherapy for colon cancer involves using medications to stimulate the patient's immune system to recognize and attack cancer cells. It targets specific proteins or receptors on the cancer cells, enhancing the body's natural defenses.
Benefits include a targeted treatment approach, fewer side effects compared to traditional therapies, and the potential for long-term remission by stimulating the immune system. It offers new hope for patients with advanced or resistant colon cancer.
Modern immunotherapy for colon cancer in Germany includes immune checkpoint inhibitors, dendritic cell vaccines, adoptive T-cell transfer, and experimental methods such as TLR agonists. These treatments help the immune system detect and attack tumor cells more effectively.
Dendritic cell therapy for colon cancer is showing promising results, especially in clinical trials. By stimulating the immune system to recognize tumor antigens, this therapy can slow disease progression, reduce relapse risk, and improve overall survival when combined with other treatments.
The cost of immunotherapy in Germany varies depending on the chosen method, the hospital, and the patient’s condition. On average, prices start from €20,000–30,000 per course. Booking Health helps patients save up to 70% by arranging treatment directly with leading German clinics.
Yes, Booking Health colon cancer support includes selecting the best clinic, negotiating costs, translating medical reports, and organizing the entire trip. Patients benefit from transparent pricing, professional guidance, and coordination throughout the whole treatment journey.
Stage 4 colon cancer immunotherapy can be effective in controlling tumor growth, especially when standard chemotherapy fails. It helps extend survival and improve quality of life by activating the immune system to attack cancer cells, even in advanced metastatic cases.
The side effects of immunotherapy for colon cancer are usually milder than those of chemotherapy. Patients may experience fatigue, appetite loss, diarrhea, or mild skin reactions. Most symptoms are temporary and manageable under medical supervision in German clinics.
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Authors:
This article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova, and Dr. Bohdan Mykhalniuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Our editorial policy, which details our commitment to accuracy and transparency, is available here. Click this link to review our policies.
Sources:
[1] Zentrum für Krebsregisterdaten. Colorectal Cancer. https://www.krebsdaten.de/Krebs/EN/Content/Cancer_sites/Colorectal_cancer/colorectal_cancer_node.html
[2] Gholamreza Roshandel, Fatemeh Ghasemi-Kebria, Reza Malekzadeh. Colorectal Cancer: Epidemiology, Risk Factors, and Prevention. Cancers (Basel). 2024 Apr 17;16(8):1530. doi: 10.3390/cancers16081530. [DOI] [PMC free article]
[3] Frontiers in Immunology. Immune checkpoint inhibitors in colorectal cancer: limitation and challenges. https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1403533/full
[4] Mahmoud Singer, Jennifer Valerin, Zhuoli Zhang et al. Promising Cellular Immunotherapy for Colorectal Cancer Using Classical Dendritic Cells and Natural Killer T Cells. Cells. 2025 Jan 22;14(3):166. doi: 10.3390/cells14030166. [DOI] [PMC free article]
[5] Frontiers in Immunology. Adoptive immune cell therapy for colorectal cancer. https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1557906/full
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Cancer immunotherapy in Germany
Article menu:
- Role of immunotherapy for colon cancer
- Types of immunotherapy for colon cancer
- How is immunotherapy for colon cancer carried out?
- Benefits of immunotherapy treatments for colon cancer
- A Medical Journey: Every Step of the Way With Booking Health
- Frequently Asked Questions of Our Patients About Immunotherapy for Colon Cancer in Germany
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