Types of Immunotherapy for Lung Cancer

Your body’s cancer cells are unique to you. That’s one reason new treatments for lung and other cancers target specific parts of our genes and immune systems that change, or mutate, and allow the disease to get a foothold.

This new type of treatment, called immunotherapy, helps your immune system fight cancer in much the same way it fights off colds and viruses.

Rev Up Your Immune System

White blood cells are your body’s main response to attacks from germs and abnormal cells like those that cause cancer. Another way our bodies fight disease is to attack antigens. This is the name for any substance your bodies doesn’t recognize and works to fight off.

Since the 1970s, cancer researchers have been looking for ways to help our immune system find and fight cancer. Doctors think our bodies know cancer cells are foreign and battle them at first. But then, like insects that get resistant to certain pesticides, cancer cells change. They make our bodies think they’re harmless so our defense system doesn’t attack.

Immunotherapy aims to get your body to fight cancer again -- and get rid of it all together. It does this in one of two ways:

  • Helps your immune system work harder
  • Places a bullseye on cancer cells so your immune system can find and destroy them

Who Can Get This Treatment?

Doctors thought for a long time that immunotherapy wouldn’t work for non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), the two most common types. But the past few years have seen several breakthroughs.

By the time most people with lung cancer are diagnosed, the disease is in an advanced stage. Options for treatment were once limited to surgery, chemotherapy, and radiation. Your doctor may suggest immunotherapy if other options haven’t worked or if your tumor has traces of certain proteins.

What Types of Treatments Are Approved?

Several immunotherapy treatments have been approved by the FDA, and others are being tested in clinical trials. There are four types of immunotherapy treatments being used or tested for lung cancer:

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Checkpoint inhibitors: Your immune system normally has checks and balances so it doesn’t go into overdrive and attack normal cells. Tumors that produce proteins called PD-L1 turn on these “checkpoints” and slow your immune system. Checkpoint inhibitors restart your immune system response so it can again fight cancer.

Monoclonal antibodies. Our bodies produce antibodies to fight foreign substances. These man-made versions act like normal antibodies, but go after cancer cells.

Vaccines: They can either prevent or treat disease. For lung cancer, doctors inject a tiny amount of your own cancer cells or a substance found in lung cancer cells into your body to restart your immune response. Preventive vaccines, like those for the flu, don’t yet work for lung cancer.

Adoptive cell therapy: Your doctor removes your T cells and treats them with cancer-fighting chemicals. They’re multiplied in a lab and put back into your body where they destroy cancer cells. Trials are under way.

What Drugs Are Available Now?

The FDA has approved several checkpoint inhibitors within the last several years to treat lung cancer:

Atezolizumab ( Tecentriq): It can help if you didn’t respond to platinum-based chemotherapy.

Duryalumab (Imfinzi): You may take this if you have a certain type of non-small cell lung cancer that cannot be removed surgically and the cancer has not spread after radiation and chemotherapy.

Nivolumab (Opdivo): You’ll take this if your lung cancer has spread after chemotherapy or other treatments.

Pembrolizumab (Keytruda): This works if cancer has spread and your tumors produce high levels of the PD-L1 protein.

FDA-approved monoclonal antibodies for lung cancer include bevacizumab (Avastin) and ramucirumab (Cyramza). These drugs cut off nutrients that help create blood vessels that feed cancer growth. Other are being tested in clinical trials. So are vaccine treatments and adoptive cell therapy.

How Do You Take These Drugs?

You’ll probably get the medication through a vein. Treatment can take place in your doctor’s office or a hospital outpatient clinic. Side effects usually result from of the boost to your immune system. You might notice:

  • Fever/chills
  • Fatigue
  • Rashes
  • Diarrhea
  • Aches in your joints or muscles
  • Vomiting/nausea

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Sometimes, these drugs work too well and your immune system goes into overdrive. That could lead to more serious side effects like inflammation of your lungs, liver, kidneys, or thyroid and pituitary glands, or autoimmune disorders that may damage an organ or gland. Alert your doctor early on to any side problems. The sooner they’re treated, the less likely they are to get worse.

Immunotherapy is one of the most promising forms of lung cancer treatment to come along in decades. The many current and planned clinical trials testing its effectiveness are clear proof. Doctors hope it will prove to be an effective weapon in their ongoing fight against lung cancer.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on May 20, 2018

Sources

SOURCES:

National Cancer Institute: “Biological Therapies for Cancer,” “Cancer Vaccines,” “Immunotherapy,” “More Immunotherapy Options Approved for Lung Cancer,” “NCI Dictionary of Cancer Terms: Antigen,” “What is Cancer?”

American Cancer Society: “Immunotherapy: Disrupting the Cancer Treatment World,” “Immunotherapy for Non-Small Cell Lung Cancer.”

Lung Cancer Alliance: “Immunotherapy for Lung Cancer: A Patient Guide.”

Cancer Research Institute: “Cancer Immunotherapy: Lung Cancer.”

Cancer Support Community: “Frankly Speaking about Cancer: Treatments for Advanced and Metastatic Lung Cancer.”

National Comprehensive Cancer Network: “NCCN Guidelines for Patients: Lung Cancer.”

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