“Immunotherapies have really caused a paradigm shift in our treatment of lung cancer patients.”
Getting a lung cancer diagnosis is a scary and overwhelming experience. You probably have many questions about your condition, in hopes to find answers to what may seem like an endless amount of unknowns. Can my lung cancer be treated? What are my treatment options? What will my life be like from now on?
Despite the prevalence of lung cancer, it’s still one of the most misunderstood conditions, much of which is due to the stigmas associated with lung cancer. Because of these stigmas, people struggling with lung cancer may have less resources available to them, which may affect their ability to understand the latest treatment options.
“Many patients don’t have a lot of information about lung cancer,” says Jorge Gomez, MD, a lung oncologist at Mount Sinai Hospital. “Some of them haven’t heard about the newer therapies that can prolong life, can improve quality of life, and have had a significant impact in the treatment of lung cancer.”
One of these newer therapies is called immunotherapy.
What Is Immunotherapy?
Immunotherapy is a type of treatment that uses the body’s immune system to help slow or stop cancer growth.
“Immunotherapies are newer therapies [that are less] toxic [than] chemotherapy and don’t attack the cancer directly like chemotherapy or targeted therapies,” says Dr. Gomez. “These drugs have [at times] been proven to be better than chemotherapy and are now approved in almost every scenario in lung cancer.”
How Does Immunotherapy Work?
Various types of immunotherapy are being developed to help the immune system recognize a tumor as something different than the normal tissues in the body. One of these immunotherapy approaches is a class of medications called checkpoint inhibitors. Here’s how they work:
An important characteristic of the immune system is to keep itself from attacking normal cells in the body. To do this, it uses “checkpoints”—which are proteins on immune cells that must be turned on (or off) to trigger an immune response.
Cancer cells sometimes use these checkpoints to essentially hide from and avoid being attacked by the immune system. “Cancer has an incredible ability to evade immune detection,” says Kevin Sullivan, MD, a lung oncologist at Monte Cancer Center, Northwell Health. “The cancer can interact with those proteins and shut off the immune response.”
That’s where the immunotherapies come to play. “These immune checkpoint inhibitors are actually antibodies that get infused into the bloodstream, and the antibody has a very specific target,” says Dr. Sullivan. The antibodies target and block the interaction between the cancer cells and the immune cells that allows the cancer to “hide” from the immune response.
“So by blocking that immune checkpoint, the immune system is now able to recognize the cancer as something foreign and attack it,” says Dr. Sullivan. “It’s basically an unleashing of the immune system against our cancer cells.”
Treating Lung Cancer with Immunotherapy
These immunotherapy drugs are given as an intravenous (IV) infusion every two or three weeks, and can be used in people with certain types of non-small cell lung cancer whose cancer starts growing again after chemotherapy or other drug treatments. Pembrolizumab can also be used as the first treatment in some people, either along with or instead of chemo.
Because these drugs work by basically removing the brakes on the body’s immune system, this may affect normal (healthy) tissue as well, which can cause side effects, such as:
- Skin reactions
- Colitis (inflammation of the colon)
- Pneumonitis (inflammation of the lungs)
- Endocrine disorders such as thyroid disease
More serious side effects can occur, but they happen less often.
“For patients who have received a lung cancer diagnosis, they have every reason to be hopeful. There are many different treatment options available, and every day we’re learning something new, and patients outcomes are improving with this disease,” says Dr. Sullivan.
Along with getting the right treatment and getting the proper nutrients during lung cancer treatment, it’s important to take care of yourself in other ways too: Here are 10 self-care tips for fighting lung cancer.
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Many patients don't have a lot of
information about lung cancer.
00:00:05,291 --> 00:00:09,215
Some of them haven't heard about the newer
therapies that can prolong life and
00:00:09,215 --> 00:00:10,711
can improve quality of life.
00:00:10,711 --> 00:00:15,061
And have had a significant impact
in the treatment of lung cancer.
00:00:15,061 --> 00:00:19,678
00:00:19,678 --> 00:00:24,257
Immunotherapies are newer therapies,
that aren't toxic like chemotherapy or
00:00:24,257 --> 00:00:28,847
don't attack the cancer directly,
like chemotherapy or targeted therapies.
00:00:28,847 --> 00:00:31,216
They activate the body's immune system so
00:00:31,216 --> 00:00:35,890
that those immune cells can then
attack the cancer cells and kill them.
00:00:35,890 --> 00:00:38,863
And these obviously
are very important things,
00:00:38,863 --> 00:00:43,360
because these drugs have been proven
to be better than chemotherapy, and
00:00:43,360 --> 00:00:46,934
are now approved in almost
every scenario in lung cancer.
00:00:46,934 --> 00:00:51,633
The immunotherapy drugs have really
caused a paradigm shift in our cancer lung
00:00:51,633 --> 00:00:54,766
patients, not only improving
00:00:54,766 --> 00:00:58,010
they've improved their long term survival.
00:00:58,010 --> 00:01:02,968
Where we're seeing the duration
of response go on in some cases
00:01:02,968 --> 00:01:06,719
beyond five year mark for
a subset of patients.
00:01:06,719 --> 00:01:11,960
Cancer has an incredible ability
to evade immune detection.
00:01:11,960 --> 00:01:15,670
All of the cells of our body hold
out proteins on the surface and
00:01:15,670 --> 00:01:19,080
our immune system does which called immune
surveillance and it goes around and
00:01:19,080 --> 00:01:22,510
looks at these different proteins but
the cancer is very tricky.
00:01:22,510 --> 00:01:26,390
Because our immune system also
holds out proteins on the surface.
00:01:26,390 --> 00:01:29,512
And the cancer can interact
with those proteins,
00:01:29,512 --> 00:01:34,204
and shut off the immune response, or
evade or hide from immune detection.
00:01:34,204 --> 00:01:39,179
So our immunotherapies, the main ones,
these immune checkpoint inhibitors,
00:01:39,179 --> 00:01:43,422
are actually antibodies that get
infused into the bloodstream, and
00:01:43,422 --> 00:01:46,620
the antibody has a very specific target.
00:01:46,620 --> 00:01:50,202
It targets that interaction
between the cancer cell and
00:01:50,202 --> 00:01:54,478
the immune system cell that enables
it to evade immune detection.
00:01:54,478 --> 00:01:59,676
So by blocking that immune check point,
the immune system is now
00:01:59,676 --> 00:02:04,983
able to recognize the cancer as
something foreign and attack it.
00:02:04,983 --> 00:02:06,190
00:02:06,190 --> 00:02:11,828
it's basically like an unleashing of the
immune system against our cancer cells.
00:02:11,828 --> 00:02:15,431
For patients who have received
a lung cancer diagnosis,
00:02:15,431 --> 00:02:17,841
they have every reason to be hopeful.
00:02:17,841 --> 00:02:21,250
There are many different
treatment options available.
00:02:21,250 --> 00:02:23,800
And every day,
we're learning something new.
00:02:23,800 --> 00:02:27,179
And patient outcomes
are improving with this disease.
00:02:27,179 --> 00:02:31,526
Patient education: Non-small cell lung cancer treatment; stage IV cancer (Beyond the Basics). UpToDate. (Accessed on September 4, 2018 at https://www.uptodate.com/contents/non-small-cell-lung-cancer-treatment-stage-iv-cancer-beyond-the-basics)
Immunotherapy for Non-Small Cell Lung Cancer. American Cancer Society. (Accessed on September 4, 2018 at https://www.cancer.org/cancer/non-small-cell-lung-cancer/treating/immunotherapy.html)