Cemiplimab is a type of immunotherapy that may help in the treatment of non-small cell lung cancer (NSCLC). However, this type of cancer is still usually fatal.

In 2021, the Food and Drug Administration (FDA) approved cemiplimab for advanced NSCLC. It is a type of immunotherapy that the FDA previously approved for squamous cell skin cancer.

Several studies suggest that cemiplimab, which Regeneron Pharmaceuticals markets as Libtayo, can help kill NSCLC cells and prolong survival.

For example, a 2020 clinical trial that helped give rise to the FDA approval found a median overall survival of 22.1 months with cemiplimab, compared with 14.3 months with just chemotherapy.

The drug can treat advanced NSCLC, which has a poor outlook.

The goal of treatment with earlier stages of NSCLC is to cure the disease. When the disease progresses, curing it becomes more difficult, so doctors focus on prolonging survival. Cemiplimab works to prolong survival.

Read on to learn about cemiplimab for NSCLC, including how effective it is, the risks and benefits, and some alternative treatment methods.

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Cancer happens when cells grow out of control, evading the immune system’s ability to kill the harmful, rapidly growing cells.

Cemiplimab is a type of immunotherapy. This means that it supports the immune system to recognize and kill cancer cells. This can slow the growth and spread of cancer.

According to a 2021 study, cemiplimab works by helping the immune system recognize NSCLCs that contain the protein anti-programmed cell death ligand-1 (PD-L1).

PD-L1 is present on some, but not all, NSCLC cells. It prevents normal cell death and allows cancer to grow out of control. By helping the immune system recognize and target PD-L1, cemiplimab supports the body to kill NSCLC.

Research on cemiplimab has focused on people with more than 50% of their cancer cells testing positive for PD-L1. It may not be an option for people with other types of NSCLC.

Cemiplimab can be a first-line treatment, which means that a person does not have to try other treatments first.

Cemiplimab improves outcomes in people with NSCLC. Advanced NSCLC, however, is typically fatal. The manufacturer of cemiplimab markets it as a drug to live longer, not a cure.

Cemiplimab does live up to this promise, based on clinical trials. In a stage 3 clinical trial that compared the drug with chemotherapy, cemiplimab participants had a median survival of 22.1 months, compared with 14.3 months with just chemotherapy.

The drug is relatively new and gained FDA approval in 2021. More research might identify additional uses, ways to make the drug more effective, or additional drug combinations.

However, people considering this drug should know that side effects are common and often unpleasant. It is important to talk with a doctor about the risks and benefits of treatment and a strategy for managing side effects.

For many people with cancer, the cost of treatment can be a barrier. It may also pose a problem for taxpayers and insurers covering treatment.

A 2021 study suggests that cemiplimab is a cost effective treatment option, with cost effectiveness increasing as the number of PD-L1 cells on the cancer increases.

NSCLC means that, under a microscope, the cells look larger than they do when compared with small cell lung cancer. Smoking is a risk factor for developing both NSCLC and small cell lung cancer.

NSCLC includes three subsets of cancer:

  • adenocarcinoma: cancer that forms in the glands that secrete mucus into the lungs; the most common type of NSCLC and most common type of lung cancer
  • large cell carcinoma: a group of NSCLC with larger cells compared with the other forms of NSCLC
  • squamous cell carcinoma: NSCLC that begins in the cells that line the bronchi of the lungs

Survival rates for both types of cancer are low, especially in the later stages of cancer, when doctors often discover a tumor. However, overall lung cancer survival is higher with NSCLC.

According to the American Cancer Society, the 5-year survival rate for all combined stages of small cell lung cancer is 7%. For NSCLC, it is 26%.

According to the manufacturer, the most common side effects in clinical trials and the percentages of participants who experienced them are as follows:

Chemotherapy was the standard treatment for people with advanced NSCLC prior to cemiplimab. This may be an option for people who do not want to use cemiplimab or whose bodies do not respond well to the drug.

In people who have stage 1, 2, or 3 cancer, the goal of treatment is to cure the disease. Cemiplimab is not typically an option in these cases.

Instead, surgery to remove the cancer, as well as part of the lung, may cure the disease. A person may then require chemotherapy, radiation, or both.

The long-term outlook for NSCLC is not favorable, though it tends to improve with cemiplimab.

Without taking into account the type of NSCLC or the treatment a person has, the American Cancer Society reports the following percentages of people with NSCLC who are alive after 5 years:

  • localized NSCLC: 64%
  • regional: 37%
  • distant: 8%

Cemiplimab is specifically for NSCLC that is advanced and for which surgery is not an option. This is usually cancer that:

  • has spread
  • is in someone who cannot undergo chemotherapy
  • is in someone who is too sick for surgery

In stage 3 clinical trials, the median survival with cemiplimab was 22.1 months, compared with 14.3 months with chemotherapy.

Cemiplimab may help people with NSCLC live longer, but it is not a cure. Living longer, however, means more time to join clinical trials if a person wants to try experimental treatments. It can also mean more time with friends and family.

However, cemiplimab can cause serious side effects similar to other cancer treatments. For this reason, a person should weigh the risks and side effects of treatment against the potential benefits.

For some people, focusing on comfort may be a better choice that empowers them to enjoy their life.

A person can talk with an oncologist to explore treatment options and assess whether a cure is possible. If it is not, cemiplimab might be a good alternative.