Small cell lung cancer (SCLC) is a less common but aggressive type of lung cancer. Symptoms of SCLC often don’t show up until later stages of cancer, when it has spread to other areas of the body.

Treatments depend on the stage of the cancer and other individual factors. The available options include chemotherapy, radiation therapy, immunotherapy, or combinations of these treatments.

Immunotherapy drugs are a relatively new treatment for SCLC. These medications are often used in combination with other drugs (like chemotherapy) to treat more advanced cases.

Let’s take a closer look at how immunotherapy works in treating SCLC, including its benefits, side effects, and more.

Immunotherapy is a type of treatment that uses your immune system to locate and attack cancer cells. It is also called biologic therapy. Biologic drugs are made from natural organisms.

There are several types of immunotherapy drugs. Currently, the only type approved by the Food and Drug Administration (FDA) to treat SCLC is immune checkpoint inhibitors.

This type of drug can help your immune system work more effectively to fight SCLC cancer cells.

Immunotherapy medications are given by intravenous injection directly into a vein by a healthcare professional. You will be carefully monitored during and after treatment for any side effects or serious reactions.

SCLC is an aggressive form of cancer that often goes undetected until it has spread to other parts of the body. When this happens, it’s called extensive stage or advanced SCLC.

Cancer cells can use your immune system to hide from being detected. Immunotherapy drugs work by helping your immune system identify and attack cancer cells.

Immunotherapy is now recommended as first-line treatment for SCLC. It’s used with certain chemotherapy drugs, like etoposide and carboplatin or cisplatin. Your doctor will talk with you about your exact treatment plan based on the type of cancer you have and other individual factors, such as your age, overall health, drug allergies, and more.

The FDA has approved a few immune checkpoint inhibitor drugs for SCLC.

Some examples include:

However, your doctor may suggest other types of immunotherapy drugs. These may be used “off label” for SCLC. This is when a drug is used for a purpose other than its approved use.

Some of these alternative options may include:

  • nivolumab (Opdivo)
  • ipilimumab (Yervoy)

Immunotherapy drugs can be used as first-line treatment for SCLC along with chemotherapy. If you respond well, you can also use them for maintenance treatment.

Talk with your doctor about the benefits and risks of each type of treatment for your situation.

Immunotherapy drugs do carry some side effects. Your doctor can provide more information about side effects of a specific medication.

Some factors that may affect how you react to a medication include your:

  • age
  • genetics
  • other health conditions you may have
  • other medications you take

The following are not complete and comprehensive lists of the side effects possible with immunotherapy medications, but they do contain some of the most common and serious ones to watch for.

Some common side effects include:

Serious side effects can include:

Risks from other conditions

Immunotherapy may not be suitable for you if you have certain other conditions. Talk with a doctor about all your health conditions and any medications you take.

Some conditions you may want to discuss include:

  • allergic reactions
  • autoimmune conditions
  • organ transplant
  • liver problems
  • lung problems
  • pregnancy (or breastfeeding)

Your doctor can provide more information on the safety of immunotherapy if you have these or other conditions.

A 2018 study and 2020 review showed that different types of immune checkpoint inhibitors combined with chemotherapy are effective as a first-line treatment for SCLC.

Another 2020 review also showed that first-line combination treatment with an immune checkpoint inhibitor drug (atezolizumab or durvalumab) and chemotherapy improved survival and quality of life for extensive stage SCLC.

However, immune checkpoint inhibitors don’t work for everyone. In order for them to work, tumors must have T cells or lymphocytes (white blood cells) present. In some cases, tumors can mutate and not allow T cells to penetrate. Immune checkpoint inhibitors may not work if this happens.

If you have certain autoimmune conditions like Crohn’s disease, multiple sclerosis, or lupus, immunotherapy drugs may not be right for you.

Your doctor will take all of your conditions into consideration when creating the best treatment plan for you.

SCLC is a fast-growing and serious type of cancer. Your outlook depends on various factors such as your:

  • stage of cancer (limited or extensive)
  • age
  • overall health
  • response to treatment

Immunotherapy treatment for SCLC is still relatively new. It is used with chemotherapy for optimal results. The length of time you’ll be on immunotherapy treatment for SCLC will depend on how your cancer is responding to treatment.

Early detection and treatment are important for improving the long-term outlook for lung cancer. Your doctor can provide more details on your treatment plan and prognosis. They will monitor you closely after treatment for several years. This is because the risk of cancer recurrence is highest in the first 5 years after completing treatment.

If you have an SCLC diagnosis, it’s natural to have questions about your condition and your outlook. New research and treatments, such as immunotherapy, are showing benefits for overall survival.

If you want to learn more about immunotherapy treatment options and how they can help with SCLC, ask your doctor about these medications, their side effects, and what to expect throughout the treatment process.