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Biologic Therapy for Lung Cancer

Lung Cancer: Immunotherapy

What is immunotherapy?

Immunotherapy is a type of treatment that boosts your body’s own immune system to help it recognize and attack cancer cells. It uses substances that are either made in the body or in a lab. These substances either boost the immune system overall or to help it better target cancer cells.

When might immunotherapy be used to treat lung cancer?

Immunotherapy is sometimes a choice for people with advanced non-small cell lung cancer (NSCLC). It is usually given after other treatments such as chemotherapy have been tried.

Immunotherapy is not yet part of the standard treatment for small cell lung cancer (SCLC), but studies are looking to see if it might be helpful. 

What immunotherapy medicines are used to treat lung cancer?

The immunotherapy medicines used to treat NSCLC are immune checkpoint inhibitors. The body normally uses certain checkpoint proteins on immune cells (or other cells) to help keep the immune system from attacking normal cells in the body. Cancer cells sometimes take advantage of these checkpoints to avoid being attacked by the immune system. But checkpoint inhibitors help the immune system recognize and attack the cancer cells. 

The checkpoint inhibitors used to treat NSCLC target PD-1. This is a protein found on certain immune cells. These medicines include:

  • Pembrolizumab

  • Nivolumab

How is immunotherapy given for lung cancer?

Before treatment starts, you will meet with a medical oncologist. This is a doctor with special training to treat cancer with medicines. The doctor will discuss your treatment choices with you. He or she will explain what you might expect. 

The immunotherapy medicines used to treat NSCLC are given as an infusion into a vein (IV). They are typically given once every 2 or 3 weeks. This is usually done in an outpatient setting. That means that you get it at a hospital, clinic, or healthcare provider's office. You can go home after the treatment is given. Less often, you may need to stay in the hospital during treatment. You'll be watched for reactions during your treatments. Since each of your treatments may last for a while, you may want to take along something that is comforting to you, such as music to listen to. You may also want to bring something to keep you busy, such as a book or mobile device.

What are common side effects of immunotherapy?

Side effects of immunotherapy tend to be different from those with other types of drug treatments such as chemotherapy. In many cases they are less severe. But they can still be serious in some people. Ask your doctor or nurse for more details about possible side effects. Tell your doctor or nurse about any changes or side effects you notice. They can suggest things to make you feel better. In most cases, you’ll stop having side effects within a few weeks after your treatment ends.

Some of the more common side effects from immunotherapy medicines can include:

  • Feeling tired

  • Cough

  • Nausea

  • Skin itching or rash

  • Loss of appetite

  • Diarrhea

  • Constipation

  • Joint pain

Less often, these medicines can cause more serious side effects. This is because they can let the immune system to attack some normal cells in the body. This can lead to serious or even life-threatening problems in the lungs, kidneys, liver, intestines, hormone-making glands, or other organs.  

Working with your healthcare provider

It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare providers about what signs to look for and when to call them. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

It may be helpful to keep a diary of your side effects. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.