Lung cancer

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Immunotherapy for non–small cell lung cancer

Some people with non–small cell lung cancer may have immunotherapy. Immunotherapy uses natural or artificial substances that change the way cells behave. Different types of immunotherapies work in different ways. Some types kill cancer cells or control or change how they behave. Other types strengthen the body’s immune system, control symptoms or lessen side effects of treatment. Immunotherapy is also called biological therapy, biotherapy or biological response modifiers (BRMs).

Immunotherapy is used with advanced or metastatic non–small cell lung cancer. You may have immunotherapy to:

  • shrink advanced or metastatic non–small cell lung cancer tumours
  • control symptoms of non–small cell lung cancer

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of immunotherapy. You may also receive other treatments.

Immunotherapy drugs used for non–small cell lung cancer

The immune system normally stops itself from attacking normal cells in the body by using specific proteins called checkpoints, which are made by some immune system cells. Non–small cell lung cancer cells sometimes use these checkpoints to avoid being attacked by the immune system.

Immune checkpoint inhibitors are drugs that work by blocking the checkpoint proteins so immune system cells (called T cells) attack and kill the cancer cells. Immune checkpoint inhibitors are monoclonal antibodies, which are substances that find and attach to a specific antigen on a cancer cell.

Certain types of immunotherapy drugs are used with advanced or metastatic non–small cell lung cancer after it has stopped responding to chemotherapy or targeted therapy:

  • pembrolizumab (Keytruda)
  • nivolumab (Opdivo)

They are given through a needle into a vein (intravenously) once every 3 weeks until the disease progresses or the side effects outweigh the benefits of having the treatment.

Another immunotherapy drug, necitumumab (Portrazza), may be used in combination with the chemotherapy drugs gemcitabine (Gemzar) and cisplatin. It may be offered as the first treatment for locally advanced or metastatic squamous non–small cell lung cancer, in people who are not able to have surgery.

Side effects

Side effects can happen with any type of treatment for non–small cell lung cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

If you develop side effects with immunotherapy, they can happen any time during, immediately after or a few days or weeks after immunotherapy. Sometimes late side effects develop months or years after immunotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of immunotherapy will depend mainly on the type of drug or drug combination, the dose, how it’s given and your overall health. Some common side effects of immunotherapy for non–small cell lung cancer are:

  • flu-like symptoms, such as fever and chills
  • fatigue
  • skin problems, including redness, itching and dryness
  • inflammation causing pain in other organs such as the lungs, thyroid or intestines
  • low levels of magnesium, calcium, phosphorous or potassium in the blood (with necitumumab)

Tell your healthcare team if you have these side effects or others you think might be from immunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Information about specific cancer drugs

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

T cell

A type of lymphocyte (white blood cell) that helps control immune response (the immune system’s reaction to the presence of foreign substances in the body), fight infection and destroy abnormal cells, including cancer cells.

Also called T lymphocyte.

antigen

A foreign substance that stimulates the immune system to produce antibodies against it.

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