Immunotherapy and Its Evolving Role with Lung Cancer Treatment
Immunotherapy is a promising treatment for lung cancer. The concept isn’t new. Since the 1970s, doctors have turned to medicine as a tool to stimulate the immune system’s defensive response to cancer. In the past, immunotherapy was used to treat kidney cancer and melanoma.
It is only recently that researchers have found ways to apply the same principles to treating certain types of lung cancer.
Changing the Treatment Outlook for Lung Cancer
Although there are several treatment options doctors can use to treat lung cancer, it isn’t unusual for these cancers to stop responding to chemotherapy after a few months. Fortunately, medical research indicates that immunotherapy might be an option when other methods of treatment prove ineffective.
In 2012, researchers reported encouraging results in a small percentage of people who used immunotherapy to treat non-small cell lung cancer. Other studies involved subsets of patients who lived for many years after receiving immunotherapy when their cancer did not respond to chemotherapy.
Whereas most developments in cancer care produce marginal improvements, immunotherapy has proven to offer dramatic, durable benefits to a limited group of patients. In fact, some patients have lived for several years beyond what would have been possible with conventional treatments.
Some patients in these groups tolerate immunotherapy medicines better than chemotherapy drugs, with fewer side effects, which means they can fight their cancer while enjoying a better quality of life.
Limitations of Immunotherapy
The challenge with immunotherapy is that it seems to work only for a minority of cancer patients. Doctors don’t always know which patients will respond to immunotherapy, although several medical studies are underway to identify which cancers and which patients respond to different immunotherapies.
Research has shown that some cancers express a particular protein called PD-L1 that predicts response to certain immunotherapy drugs. This test can be ordered by your physician.
Who Does Immunotherapy Work For?
For patients whose lung cancer expresses PD-L1, a recent study has shown immunotherapy with a drug called pembrolizumab was superior to chemotherapy as the first treatment for advanced lung cancer.
For other patients, chemotherapy may be the preferred treatment but when chemotherapy stops working, immunotherapy, with drugs like pembrolizumab, nivolumab, or atezolizumab, may be a good option. In this setting, immunotherapy would be expected to work for about 20 percent of patients. Doctors are not sure if the other 80 percent of patients will respond to other types of immunotherapy.
Clinical trials are currently studying the effects of new immunotherapy drugs and new combinations, which could become available soon.
Is Immunotherapy Right for You?
Immunotherapy isn’t right for everyone with lung cancer. If you have a serious autoimmune condition, it’s less likely to be a suitable treatment option for you. In fact, it could make your condition worse. Depending on the type of lung cancer you have, there might be other treatments that your oncologist would prefer to use instead.
Don’t rule out asking your oncologist if immunotherapy is an option for you. Most doctors are happy to discuss all available treatments with their patients and explain why they are or are not suitable. You might even be a candidate to join a clinical trial for a new immunotherapy drug.
If you have nonsmall-cell lung cancer, talk to your oncologist about immunotherapy. This treatment may be a good option if other treatments aren’t working for you. With new immunotherapy drugs in development, there may be an emerging medicine - or combinations of medicines - that could help control your cancer or send it into remission.