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Immunotherapy for Lung Cancer

Medically reviewed by Seunggu Han, MD on October 30, 2017Written by Valencia Higuera on October 30, 2017
immunotherapy for lung cancer

Lung cancer is a serious health concern and the leading cause of cancer death. It’s important to receive an early diagnosis so you can begin treatment. This can result in a better outcome and may prevent cancer from spreading to other parts of your body.

After diagnosing and staging lung cancer, your doctor will decide the best treatment. There are various treatments available based on your diagnosis. This includes chemotherapy and radiation to kill cancer cells, or surgery to remove cancerous tumors. Your doctor may also recommend immunotherapy along with these treatments.

Immunotherapy is sometimes used when other treatments fail. But it’s also available as a first line of defense in earlier stages of cancer.

Here’s what you need to know about immunotherapy to determine if it’s right for you.

What is immunotherapy?

Immunotherapy differs from other cancer treatments because it stimulates your immune system. This response allows your body to recognize malignant cells. Then your immune system attacks these cells before they divide and spread to other parts of your body.

Most immunotherapy drugs that are available treat non-small cell lung cancer (NSCLC). NSCLC is the most common type of lung cancer, making up about 80 percent to 85 percent of lung cancers. Subtypes of NSCLC include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

The immune system’s job is to protect the body from invaders. These invaders include bacteria, fungus, viruses, and anything else that can make us sick. When the immune system recognizes an invader, it releases white blood cells, or T-cells, which fight infections.

With cancer, though, the immune system doesn’t always recognize malignant cells as invaders. There are proteins on the surface of T-cells, known as PD-1 and CTLA-4. These act as checkpoints or “off” switches that prevent your T-cells from attacking other cells in your body. These stop your body from attacking normal cells. But these proteins can also stop your body from attacking abnormal cells.

Cancer cells are abnormal, but they’re still your own cells. And sometimes, the immune system can’t distinguish between healthy cells and unhealthy cells. Because of these checkpoints, cancerous cells can remain undetected in the body and spread to other parts of the body.

Immunotherapy targets these checkpoints and turns your immune system’s response “on.” This helps your body recognize cancerous cells as dangerous. In turn, this prompts your immune system to attack and destroy these cells.

Types of immunotherapy for lung cancer

If you’re a candidate for immunotherapy, current therapies include PD-1 inhibitors. These are approved by the U.S. Food and Drug Administration (FDA). These target PD-1 receptors and prevent T-cells from attacking other cells in the body. This allows the immune system to recognize cancerous cells, either destroying or slowing the growth of these cells. These drugs include:

  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)
  • atezolizumab (Tenectriq)

Immunotherapy is given intravenously (through an IV) every two to three weeks.

These are the only drugs currently approved by the FDA. But other immunotherapy drugs for lung cancer are being studied in clinical trials. These include CTLA-4 inhibitors. These also stimulate T-cells to find and kill cancer cells before they spread or grow. This type of immunotherapy has been studied for both NSCLC and small cell lung cancer.

Some clinical trials have also tested vaccines and adoptive T-cell therapy for the treatment of lung cancer. Vaccines are being developed to boost the body’s immune system response and treat existing lung cancers. Adoptive T-cell therapy involves removing your own immune T-cells from the body, and then reengineering the cells so they can search out and kill cancer cells.

Side effects of immunotherapy

Depending on your lung cancer stage, your doctor may recommend immunotherapy by itself. Or they may recommend combined immunotherapy with other cancer treatments. Although an effective treatment for lung cancer, there are risks associated with this therapy. Side effects of immunotherapy may include:

  • fatigue
  • nausea
  • itching
  • skin rash
  • loss of appetite
  • constipation
  • diarrhea

Because immunotherapy stimulates the body’s immune system, there’s also the risk of your immune system attacking other parts of your body. This includes the major organs. This type of attack could be life-threatening. It requires strong corticosteroids to suppress your immune system.

Outlook

Immunotherapy is a new approach to treating lung cancer. This may improve your quality of life and treat cancer during early stages of the disease. It may also treat cancer that doesn’t respond to other treatments. Speak with your doctor to see if immunotherapy is right for you, and ask if clinical trials are an option.

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