This treatment option uses medicines to stimulate the body’s immune system so that it can fight the cancer cells more effectively.
Immunotherapy has changed the way doctors treat many types of cancer, including lung cancer.
In this article, we look at how immunotherapy works, how it might help people with lung cancer, and what the side effects might be.
What is immunotherapy for lung cancer?
Immunotherapy uses medicine to stimulate the immune system and attack cancer cells.
Immunotherapy is a relatively new treatment option for a variety of cancers, including lung cancer. Immunotherapy helps the body’s existing immune system recognize and attack cancer cells.
There are a few different types of immunotherapy for fighting lung cancer. These include:
- immune checkpoint inhibitors
- adoptive T cell therapy
- therapeutic vaccines
The different types of therapies offer alternative ways for the body to attack cancer cells.
There is still a need for further research into how effective these treatments are, who benefits most from their use, and their overall safety.
How does immunotherapy work?
The different types of immunotherapy work in various ways.
Immune checkpoint inhibitors
A person’s immune system works by constantly surveying the body for foreign objects, such as bacteria, fungi, and viruses.
Immune cells carry certain molecules that stop the immune system from attacking normal cells and tissue. Normal or regular cells use these molecules as a checkpoint. However, cancer cells use these same checkpoints to avoid detection from the immune system.
Immune checkpoint inhibitors prevent the cancer cells from using these checkpoints against the immune system. When the cancer cells can no longer use the checkpoints, the immune system will target and attack the cancer cells.
The United States Food and Drug Administration (FDA) have approved a few varieties of immune checkpoint inhibitors to treat lung cancer. These drugs come in two categories: PD1 or PD-L1 inhibitors and CTLA-4 inhibitors.
PD1 or PD-L1 inhibitors block lung cancer’s ability to use the checkpoints found on T cells. T cells patrol the body, looking for threats. Preventing cancer cells from using these checkpoints allows the T cells to target and attack cancer cells.
Examples of PD1 or PD-L1 inhibitors include:
- nivoluma
- durvalumab
- atezolizumab
- pembrozulimab
- avelumab
CTLA-4 inhibitors work in a slightly different way to the PD1 or PD-L1 types. CTLA-4 inhibitors get the T cells to work, making them actively search for and destroy cancer cells.
There are currently not as many CTLA-4 options available. In fact, only one type, ipilimumab, has been approved, and it is being used successfully to treat melanoma cancers. Research is still taking place into CTLA-4 inhibitors for lung cancer treatment.
Adoptive T cell therapy
Adoptive T cell therapy involves the removal of T cells from a person’s body. Once removed, the T cells are reprogrammed to seek out and destroy cancer cells and then put back in the person’s body.
So far, adoptive T cell therapy shows some promising results in treating cancers.
More research is needed before adoptive T cell therapy will be widely used for treating lung cancer, however.
Therapeutic vaccines
Therapeutic vaccines work by targeting characteristics of cancer cells known as antigens that tell the body the cells are not wanted.
The vaccines target antigens typically found in people with lung cancer. These antigens include MAGE-3 and NY-SEO-1, but scientists are currently testing vaccines against other antigens to treat lung cancer.
Many vaccines are currently being trialed to test how they will work with the various types of lung cancer.
Who needs immunotherapy?
People who have certain types of non-small cell lung cancer (NSCLC) are typical recipients of immunotherapy.
Often, immunotherapy is given to people whose cancer has returned after treatment. Sometimes, however, immunotherapy is a primary treatment and is often coupled with chemotherapy.
Unfortunately, doctors are not yet able to predict which people will benefit from immunotherapy.
More research is needed to identify why some people respond very well while others do not respond at all.
Benefits, risks, and side effects
People who respond well to immunotherapies will experience fewer side effects than they will from traditional chemotherapy treatment.
When immunotherapy works, it can also effectively eliminate and stop recurrences of cancer.
Some of the milder side effects include:
- joint pain
- fatigue
- cough
- loss of appetite
- diarrhea
- nausea
- itching
- skin rash
- constipation
Unfortunately, some people who use immunotherapy are at risk of over-activating their immune system. In these more extreme cases, the immune system starts to attack healthy tissue and organs in the person’s body.
If this happens, people should stop immunotherapy treatment and take steroids to slow the immune system down.
Alternatives
There are a variety of alternatives to immunotherapy. Many of these options have been in use for some years.
Some evidenced-based alternatives include:
- surgery to partially remove the lung and some lymph nodes
- chemotherapy
- radiation
- targeted therapy
Some of these alternatives can also be combined to treat lung cancer.
Researchers are very optimistic for the future of immunotherapies, but they also recognize there is still lots to learn.
The amount of research into the effectiveness and safety of immunotherapy for people with lung cancer is limited but growing.
Early and continued studies offer hope that immunotherapy treatment could be an important way to fight lung cancer as well as other forms of cancer.
Some researchers are currently looking into the reason why immunotherapy is not an effective cancer treatment for all people. Research is also focusing on “personalized medicine,” which entails predicting or determining who would benefit the most from immunotherapy.
According to researchers from the Translational Lung Cancer Research, further research is needed to identify which people will benefit most from immunotherapy treatments.
Outlook
Immunotherapy for treating people with both early and advanced stages of lung cancer has a promising future.
Current research has shown that various types of immunotherapy have had excellent results when treating either lung cancer or other types of cancers, such as skin cancer.
Many researchers point to immunotherapy as being the future of cancer treatment. Over the next several decades, it is likely that lots of research will take place, and immunotherapy will continue to receive a lot of attention.