Is immunotherapy right for my lung cancer?
- Immunotherapy has been shown to improve survival in lung cancer and is a commonly used treatment.
- Immunotherapy is used routinely for stage 3 and 4 lung cancer and is being studied in earlier stage disease.
- The choice to have immunotherapy alone, in combination with chemotherapy, or dual immunotherapy is an individualized decision based upon specific patient and tumor related factors.
But available immunotherapy drugs are not for everyone, and your oncologist can help you determine if they may be beneficial for you. Considerations include the molecular characteristics of your tumor and the therapies you have tried in the past as well as your overall health.
Read MoreWhat is immunotherapy?
Immunotherapy is a type of treatment that works to harness your body’s immune system to attack and kill cancer cells. Cancer cells can hide from the immune system and can grow uncontrolled. Immunotherapy works to remove this camouflage allowing immune cells to recognize the cancer as an invader and attack. Because immunotherapy works using your body’s immune system the side effects are very different than chemotherapy. Chemotherapy works as a poison to kill cancer cells and stop them from growing. Since chemotherapy is a poison it affects every cell and causes many side effects that are difficult for patients to tolerate. Immunotherapy does not have these same side effects making it a very attractive treatment option for patients with lung cancer.When is immunotherapy used for lung cancer?
The role of immunotherapy in treating lung cancer has rapidly evolved and expanded over the last five years. Immunotherapy was initially used for patients with Stage 4 or metastatic lung cancer. However, now it is used for patients with stage 3 lung cancer following radiation and chemotherapy and is also being studied in even more localized forms of lung cancer including stage 1 and 2 diseases.Immunotherapy has been a major advancement in the treatment of lung cancer and has allowed patients to live longer while experiencing fewer side effects compared with chemotherapy.
Immunotherapy is given for metastatic or stage 4 lung cancer and can be delivered in several different ways depending on factors specific to each patient and situation. In some circumstances, a single immunotherapy agent is given alone. In this scenario, the tumor is assessed by a doctor called a pathologist who performs special studies on the tissue obtained from a biopsy or surgery. The tissue is examined for the presence of PD-L1 which is a marker that helps doctors know if immunotherapy is the right choice for each patient and also gives the treating team knowledge about how well the tumor will respond to immunotherapy. In circumstances where these numbers are very high patients may be treated with immunotherapy alone without chemotherapy.
RELATED: What Is PD-L1 in Lung Cancer And Why Does It Matter?
In other circumstances, patients may be treated with a combination of both immunotherapy and chemotherapy. This is most often the situation when PD-L1 numbers are low. In this setting, studies have shown that the addition of chemotherapy is needed. Finally, in certain circumstances, two immunotherapy agents may be given at the same time. This may be the case with advanced disease or when an aggressive approach is desired by the treating team.
It is important to note that each patient is treated uniquely and immunotherapy for lung cancer is not a one size fits all approach. Many factors including the tumor stage, the percent of cells staining for PD-L1, the presence or absence of biomarkers, a patient’s overall health status, and the patient’s goals of treatment will factor into deciding on which treatment approach is best.
RELATED: Immunotherapy Has Changed The Game For Lung Cancer
What are the side effects of immunotherapy?
Immunotherapy has a different side effect profile compared with chemotherapy. Immunotherapy works by activating the body’s immune system to attack and kill cancer cells. In some circumstances, this can also cause the body to attack normal organs. Because of this immunotherapy can cause many side effects and it is recommended that you discuss any changes you are experiencing with your treatment team immediately even if you think it is not related to your cancer. Although immunotherapy can cause a large range of side effects more common side effects to include infusion reactions, fatigue, inflammation of the lungs, diarrhea, rashes, and autoimmune conditions.
The take-home message.
Immunotherapy has become an important and commonly used method of treating lung cancer. Immunotherapy has been shown to improve survival in patients with lung cancer and is often better tolerated compared to chemotherapy. Immunotherapy was initially studied and primarily used for advanced and metastatic disease but is now also used to treat stage 3 lung cancer. Multiple clinical trials are looking to assess if immunotherapy is beneficial in earlier-stage diseases. The choice of immunotherapy agent, the decision to give immunotherapy alone or in combination with chemotherapy, or the choice to give dual immunotherapy is an individual decision based upon specific factors. Immunotherapy has changed the game in lung cancer and you should discuss the role immunotherapy may have in treating your lung cancer.
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