After you’ve been diagnosed with non-small cell lung cancer (NSCLC), your doctor will go over your treatment options with you. If you have early-stage cancer, surgery is usually the first choice. If your cancer is advanced, your doctor will treat it with surgery, chemotherapy, radiation, or a combination of the three.

Immunotherapy can be a second-line treatment for NSCL. This means you might be a candidate for immunotherapy if the first drug you try doesn’t work or stops working.

Sometimes doctors use immunotherapy as a first-line treatment along with other drugs in later-stage cancers that have spread throughout the body.

Immunotherapy: How it works

Immunotherapy works by stimulating your immune system to find and kill cancer cells. The immunotherapy drugs used to treat NSCLC are called checkpoint inhibitors.

Your immune system has an army of killer cells called T cells, which hunt down cancer and other dangerous foreign cells and destroy them. Checkpoints are proteins on the surface of cells. They let the T cells know whether a cell is friendly or harmful. Checkpoints protect healthy cells by preventing your immune system from mounting an attack against them.

Cancer cells can sometimes use these checkpoints to hide from the immune system. Checkpoint inhibitors block checkpoint proteins so that T cells can recognize cancer cells and destroy them. Basically, these drugs work by removing the brakes on the immune system’s response against cancer.

Checkpoint inhibitors for NSCLC

Four immunotherapy drugs treat NSCLC:

  • Nivolumab (Opdivo) and pembrolizumab (Keytruda) block a protein called PD-1 on the surface of T cells. PD-1 prevents T cells from attacking the cancer. Blocking PD-1 allows the immune system to hunt down and destroy the cancer cells.
  • Atezolizumab (Tecentriq) and durvalumab (Imfinzi) block another protein called PD-L1 on the surface of tumor cells and immune cells. Blocking this protein also unleashes the immune response against the cancer.

When can you get immunotherapy?

Doctors use Opdivo, Keytruda, and Tecentriq as second-line therapy. You might get one of these drugs if your cancer has started to grow again after chemotherapy or another treatment. Keytruda is also given as a first-line treatment for late-stage NSCLC, together with chemotherapy.

Imfinzi is for people with stage 3 NSCLC who can’t have surgery, but whose cancer hasn’t gotten worse after chemotherapy and radiation. It helps to stop the cancer from growing for as long as possible.

How do you get immunotherapy?

Immunotherapy drugs are delivered as an infusion through a vein into your arm. You’ll get these drugs once every two to three weeks.

How well do they work?

Some people have experienced dramatic effects from immunotherapy drugs. The treatment has shrunk their tumors, and it has stopped the cancer from growing for many months.

But not everyone responds to this treatment. The cancer might stop for a while, and then come back. Researchers are trying to learn which cancers respond best to immunotherapy, so they can target this treatment to the people who will get the most benefit from it.

What are the side effects?

Common side effects from immunotherapy drugs include:

  • tiredness
  • cough
  • nausea
  • itching
  • rash
  • appetite loss
  • constipation
  • diarrhea
  • joint pain

More severe side effects are rare. Because these drugs increase the immune response, the immune system could launch an attack on other organs like the lungs, kidneys, or liver. This could be serious.

Takeaway

NSCLC often isn’t diagnosed until it’s at a late stage, making it harder to treat with surgery, chemotherapy, and radiation. Immunotherapy has improved the treatment of this cancer.

Checkpoint inhibitor drugs help to slow the growth of NSCLC that has spread. These drugs don’t work for everyone, but they can help some people with late-stage NSCLC go into remission and live longer.

Researchers are studying new immunotherapy drugs in clinical trials. The hope is that new drugs or new combinations of these drugs with chemotherapy or radiation could improve survival even more.

Ask your doctor if an immunotherapy drug is right for you. Find out how these drugs might improve your cancer treatment, and what side effects they could cause.