Immunotherapy is a type of drug treatment that may benefit people with certain kinds of lung cancer.
The immune system defends the body from unwanted invaders, including cancer cells. However, cancer finds ways around its defenses.
Immunotherapy aims to stop cancer cells from avoiding the immune system, or it can stimulate the immune system to fight cancer cells more effectively.
In the United States, 47 immunotherapies covering most types of cancer have approval from the Food and Drug Administration (FDA), according to the Cancer Research Institute (CRI). Immunotherapy has changed the way doctors treat many types of cancer, including lung cancer.
This article will look at how immunotherapy works, how it might help treat lung cancer, and the side effects.
Immunotherapy is a relatively new treatment option for various conditions, including lung cancer and other types of cancer. It helps the body’s immune system recognize and attack cancer cells.
Several types of immunotherapy may help treat lung cancer. They work in different ways and include:
- immune checkpoint inhibitors
- T cell transfer therapy
- monoclonal antibodies
- therapeutic vaccines
- immune system modulators
Researchers are still looking into how effective these treatments are, who they can benefit, and their overall safety.
The immune system seeks and destroys unwanted elements — such as bacteria, fungi, and viruses — to prevent them from causing harm. However, immune cells must also carry proteins that stop the system from attacking healthy cells and tissue.
These proteins act as a checkpoint in a healthy body. However, cancer cells use them to avoid detection from the immune system. This is how cancer cells are able to survive.
When cancer cells can no longer use the checkpoints, the immune system will target and attack the cancer cells.
Treatment for lung cancer includes drugs that target proteins known as CTLA-4 and PD-1 or its partner protein, PD-L1, which act as checkpoints.
Here are some examples of immune checkpoint inhibitors.
PD-1 or PD-L1 inhibitors
PD1 or PD-L1 inhibitors block lung cancer’s ability to use the checkpoints present on T cells. Preventing cancer cells from using these checkpoints allows the T cells to target and attack cancer cells.
Examples of PD-1 or PD-L1 inhibitors include:
- nivolumab (Opdivo)
- cemiplimab (Libtayo)
- pembrozulimab (Keytruda)
- atezolizumab (Tecentriq)
- durvalumab (Imfinzi)
CTLA-4 inhibitors work slightly differently. They trigger the T cells to search actively for cancer cells and destroy them.
These drugs can have adverse effects, but it is not possible to know in advance how they will affect an individual.
Some common side effects include:
Less commonly, inflammation may cause symptoms in the following areas:
Adoptive T cell therapy, also known as T cell transfer therapy, enhances the body’s ability to fight cancer.
It involves removing T cells from the body and reprogramming them to seek and destroy cancer cells. Then, a doctor will return the T cells to the person’s body through a needle in a vein.
The reprogramming happens in a laboratory and can take 2–8 weeks. During this time, a person may receive chemotherapy and radiation therapy to remove cancer cells.
Adoptive T cell therapy has shown some promise in treating cancers, but more research is necessary before doctors can use it more widely.
Possible side effects include:
A therapeutic cancer vaccine fights lung cancer cells in a person who already has lung cancer. This type of vaccine does not prevent cancer, as it targets cancer cells rather than the cause of cancer.
Cancer cells contain substances called antigens that relate specifically to cancer. Non-cancerous cells do not contain these antigens. The vaccine helps the immune system identify these antigens and destroy the cells that contain them.
In theory, vaccines could produce fewer or less severe adverse effects than other treatment options, as their target is very specific.
However, this treatment remains experimental. None of the vaccines yet have FDA approval, but
These boost the body’s immune response. Doctors may use them to fight cancer or manage the side effects of other treatments. There are several types.
Cytokines are proteins that white blood cells produce to help the body fight infection. Examples of cytokines that may play a role in this kind of treatment are interferons and interleukins (ILs).
Some drugs cause cells to release IL-2 and also prevent tumors from forming new blood vessels. They include:
Hematopoietic growth factors are another type of cytokine that can help manage the adverse effects of chemotherapy.
The adverse effects of immunomodulators include flu-like symptoms, such as:
- fever and chills
- weakness and fatigue
- dizziness and nausea
- headache, muscle, and joint aches
Immunotherapy may help people with certain types of NSCLC.
Depending on the type, doctors may use it:
- as a first-line therapy
- in the later stages
- alongside chemotherapy or radiation therapy
- to help manage the adverse effects of other treatments
The side effects will depend on the type of immunotherapy a person receives. They mostly result from an over-enhancement of the immune system. This can cause the body to attack healthy cells.
Common side effects include:
- pain, swelling, soreness, or rash at the injection site
- flu-like symptoms, such as fever and fatigue
- fluid retention, leading to swelling
- heart palpitations
- a higher risk of infection
- sinus congestion
- organ inflammation
Some people may experience an allergy or inflammatory reaction. In rare cases, this can be life threatening. A person should let a doctor know about any unusual reactions they experience.
Immunotherapy is an emerging area of treatment for cancer, and research is ongoing.
Some people may be interested in joining clinical trials. This can offer the person a chance to try new drugs or new ways of using them. These new approaches may be more effective than the treatment they have received before.
When people join clinical trials, they work together with doctors, nurses, and researchers and receive regular monitoring and support while participating in the trial. Even if a person receives a placebo during a trial, the team will also ensure that they receive other types of treatment, so they will not miss out on therapy.
The CRI note that clinical trials for cancer drugs are “generally safe,” though there may be adverse effects, as with other treatments.
Anyone interested in finding out more about clinical trials should speak with a doctor. The CRI also provide information on available trials.
Immunotherapy is an emerging treatment for cancer that may help treat lung cancer in some people.
The FDA have approved several options. As research continues, more types of immunotherapy may become available.