Starting Immunotherapy: What to Expect

Medically Reviewed by Paul Boyce, MD on March 08, 2024
3 min read

Lung cancer has long been considered one of the most challenging cancers to treat because it has usually spread by the time you’re diagnosed. When it spreads to other body parts, doctors refer to it as metastatic. The newest field of cancer medicine, called immunotherapy, is an effective treatment option for metastatic lung cancer.

Getting Started

This type of treatment helps your immune system better find and destroy cancer cells. The types that are approved for lung cancer right now are called checkpoint inhibitors. They bring cancer cells out of hiding so your body’s natural defense system can find and kill them. There following FDA-approved immunotherapy drugs for NSCLC: atezolizumab (Tecentriq), cemiplimab-rwlc (Libtayo), durvalumab (Imfinzi), nivolumab (Opdivo), and pembrolizumab (Keytruda).

Ipilimumab (Yervoy) is another checkpoint inhibitor that can be used in NSCLC, but it works at a different place on the T cells and is not used alone as a treatment.

Your doctor may suggest this type of treatment if you have certain types of non-small-cell lung cancer. It may be the first thing you try. Or you could get it if your cancer comes back after chemo or other drug treatments. Ask your doctor which type of immunotherapy drug you will be taking.

These drugs should be used with caution if you have an autoimmune disorder like lupus or rheumatoid arthritis.

Many other types of lung cancer immunotherapy medicines and treatments are in clinical trials. Your doctor may suggest you take part in one of these studies if other treatments haven’t worked.

Where and When You’ll Get Treatment

You’ll go to your doctor’s office, a medical center, or a hospital. You’ll get the drug by infusion through an IV (intravenous) line, usually in your arm.

Each treatment takes about 30 to 90 minutes. Depending on the drug used, you’ll receive a dose every 2 to 3 weeks until the cancer shows signs of improvement or you have certain side effects. The process will probably last a few months.

Your cancer care team will provide specific details regarding the location, dates, and length of your immunotherapy treatment plan.

Side Effects and Complications

Always tell your doctor about any side effects you have. It’s important for them to figure out if your symptoms are caused by the treatment or a sign that your cancer may be getting worse. Managing side effects early and well can help you stick to your cancer treatment plan.

Immunotherapy can cause flu-like side effects. This means your immune system is hard at work. Common symptoms include:

  • Fatigue
  • Cough
  • Loss of appetite
  • Muscle aches and pains
  • Joint pain

Other side effects of checkpoint inhibitors for lung cancer include:

  • Nausea
  • Diarrhea
  • Constipation
  • Itching
  • Rash

Many of these problems are easy to treat with over-the-counter medicines.

Severe side effects are less common. But sometimes, checkpoint inhibitors cause your immune system to attack otherwise healthy tissue. This can lead to life-threatening inflammation in your lungs, liver, kidneys, intestines, and other parts of the body. You may have to stop immunotherapy and get medicines to quiet down your immune system.

Pneumonitis (inflammation of the lungs) is one serious side effect that often affects people taking checkpoint inhibitors. It can make it hard to breathe. You’ll need immediate treatment.

Because immunotherapy for lung cancer is so new, doctors aren’t sure what the long-term effects or complications might be. They can include diabetes and thyroid problems, which would require ongoing medical care.

What Happens After Treatment Stops?

Doctors consider checkpoint inhibitors a breakthrough that can help people with advanced lung cancer live longer. However, they don’t work for everyone. Stay in touch with your doctor during treatment, and always go to all your follow-up appointments. Blood tests and imaging scans are done to check for signs of cancer disappearance or growth.

Ask your doctor how you can tell if your treatment isn’t working.