Immunotherapy Treatment for Small-Cell Lung Cancer

For more than three decades, care for small-cell lung cancer (SCLC) remained mostly the same. That’s changing now -- doctors have a new option called immunotherapy. This line of treatment uses your body’s own immune system to fight cancer.

What Is Immunotherapy?

The immune system is your body’s defense against harmful substances. It attacks foreign particles, like germs and viruses. But cancer can confuse your body. As cells change and grow out of control, your immune system may not think them as a threat.

Scientists have developed drugs to help your immune system target and destroy cancerous cells. They include:

Immune checkpoint inhibitors: Some immune cells have proteins that act as off switches. These “checkpoints” prevent them from killing cancer cells. Immune checkpoint inhibitors target these proteins and allow immune cells to attack the cancer. 

Cancer vaccines: These substances kick-start an immune system response. They can prevent or treat certain cancers. Scientists are beginning to study vaccines for SCLC.

Which Drugs Treat SCLC?

There are a few FDA-approved immunotherapy drugs for SCLC.

  • Nivolumab (Opdivo) and pembrolizumab (Keytruda). You might take these immune checkpoint inhibitors if your cancer doesn’t respond or returns after treatment with a certain chemotherapy.
  • Atezolizumab (Tecentriq). You might take this immune checkpoint inhibitor along with chemotherapy.

When Do You Get Immunotherapy?

Depending on how much your cancer has spread, your cancer doctor will usually recommend treatment with surgery, chemotherapy, or radiation. But SCLC is an aggressive disease that grows quickly. It often becomes resistant to the chemotherapy drugs. Most of the time, the cancer returns.

That’s when it’s time to try immunotherapy. Because scientists are still studying the drugs, doctors are careful about when to prescribe them. They can cause serious side effects, like inflammation of the organs. Your doctor will weigh the pros and cons. Most people get immunotherapy after two or more rounds of chemotherapy.

How Do You Get the Treatment?

You go to your doctor’s office, a clinic, or the outpatient unit of a hospital. An IV will deliver the immunotherapy into your vein. The process usually takes around an hour. Depending on the drug, you’ll receive treatment every few weeks.

Your doctor will decide how long you’ll get this medication. Usually the goal of is to prevent the cancer from getting worse instead of curing the disease.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on August 22, 2019

Sources

SOURCES:

The Oncologist: “The Future of Immunotherapy in the Treatment of Small Cell Lung Cancer.”

American Cancer Society: “Small Cell Lung Cancer Treatment,” “What Is Immunotherapy?”

Meaghan L. Khan, MD, oncologist, Baylor Scott & White Healthcare.

Antonio Giordano, MD, PhD, director, Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University; professor of pathology, University of Sienna, Italy.

Scott Antonia, MD, PhD, chair, department of thoracic oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; professor, oncologic Sciences, University of South Florida College of Medicine, Tampa, FL.

NIH: “FAQ: ClinicalTrials.gov - Clinical Trial Phases.”

National Comprehensive Cancer Network: “About NCCN.”

Merck: “Frequently Asked Questions about pembrolizumab Expanded Access Program.”

Clinical Trials.gov: “SC16LD6.5 in Recurrent Small Cell Lung Cancer.”

OncoMed Pharmaceuticals: “Development Pipeline.”

Clinical Cancer Research: “Targeting Notch Signaling with a Notch2/Notch3 Antagonist (Tarextumab) Inhibits Tumor Growth and Decreases Tumor-Initiating Cell Frequency.”

Abstract presented at the 2016 ASCO Annual Meeting: “Safety and efficacy of single-agent rovalpituzumab tesirine (SC16LD6.5), a delta-like protein 3 (DLL3)-targeted antibody-drug conjugate (ADC) in recurrent or refractory small cell lung cancer (SCLC).”

American Cancer Society: “Immunotherapy for Small-Cell Lung Cancer.”

FDA: “FDA approves atezolizumab for extensive-stage small-cell lung cancer,” “FDA approves pembrolizumab for metastatic small-cell lung cancer.”

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