Immunotherapy for Lung Cancer
There was a lot of excitement from new studies out recently showing strong responses in using new immunotherapy drugs in combination with older drugs to treat a common type of lung cancer.
Our UW Carbone lung cancer specialists have experience with these new therapies both in clinical trials and in the drugs approved by the FDA.
Dr. Anne Traynor offers some perspective:
What is immunotherapy for lung cancer?
Immunotherapy is a treatment that uses the body’s own anti-cancer immune blood cells to kill cancer cells, including lung cancer cells. Typical chemotherapy drugs kill cancer cells directly, usually by stopping cancer cells from replicating. Chemotherapies are successful in some patients, but too often the cancer cells change and these drugs are no longer effective. Improved cancer medicines are urgently needed.
Immunotherapy works very differently than chemotherapy. We are all born with immune blood cells that are constantly fighting infection, cancer, and other diseases in our bodies all our lives. Scientists have been working in the laboratory for over 40 years trying to train these immune blood cells to fight a patient’s cancer. Those scientists learned that one of the very first things the lung cancer cells do when they set up shop in the patient’s body is to turn off the local anti-cancer immune blood cells that patients need to fight their cancer. These new immunotherapy drugs turn those cancer fighting immune blood cells back on, unleashing one’s own immune cells to attack and kill cancer cells.
Therefore, these immunotherapy drugs offer a very different way to kill cancer cells. Immunotherapies began being approved for patients with lung cancer by the FDA in early 2015. There is an incredible amount of research going on worldwide, searching for better and safer immunotherapy therapies.
What are the side effects of immunotherapy for lung cancer?
Both immunotherapy and chemotherapy drugs cause fatigue and nausea or vomiting, but immunotherapy treatments can sometimes over-activate the cancer fighting immune blood cells in patients. In these situations, the patient’s immune cells irritate normal tissues in their bodies. Many times the side effects can improve after taking oral steroid pills, but very infrequently a patient receiving immunotherapy may have to take additional medications to reverse side effects.
How successful is immunotherapy for lung cancer?
Immunotherapy treatments are showing tremendous promise for some patients with lung cancer. There is a great deal of research to find the best way to predict which patients will benefit the most from immunotherapy treatments.
Many clinical trials are showing that immunotherapy treatments work better than chemotherapy drugs in slowing down lung cancer. Most of these studies are with patients who have lung cancer that has spread throughout the body. In this situation, immunotherapy treatments appear to slow down the lung cancer in twice as many patients as chemotherapy (45 percent vs 28 percent), and can delay worsening of the cancer by four or more months.
Adding an immunotherapy drug to chemotherapy also seems to improve the ability to slow down the cancer. For example, a recent clinical trial showed that adding the immunotherapy drug, pembrolizumab, to chemotherapy helped patients go longer time periods before they need a second type of anti-cancer treatment. Adding pembrolizumab to patients in this study doubled the rate of tumor shrinkage. Lastly, patients who received pembrolizumab added to chemotherapy experienced fewer side effects.
Susan Lampert Smith
Date Published: 04/23/2018