Immunotherapy for Lung Cancer

What is immunotherapy for lung cancer?

Immunotherapy for lung cancer is an innovative and relatively new treatment option. For some patients, immunotherapy may be used on its own. More often, it is combined with other treatments such as chemotherapy or radiation to make treatment more effective.

Your care team will recommend how immunotherapy fits into your treatment plan based on your type of lung cancer, its stage, and your overall health.

Immunotherapy is a category of treatments that help your body's natural immune response fight cancer more successfully. Some lung cancer immunotherapy treatments increase the number of anti-cancer immune cells in your body, and others modify your immune cells to make them more effective.

There are also lung cancer immunotherapy drugs that work by helping your immune system recognize cancer cells as targets, even when the cancer cells appear similar to normal cells.

Our approach to lung cancer care

At the Mass General Brigham Cancer Institute, you receive care from an experienced team dedicated to diagnosing and treating lung cancer. Together, they develop a personalized treatment plan based on the type and stage of cancer, genetic and molecular findings, and your overall health and goals.

Who is a candidate for immunotherapy for lung cancer?

Not every patient with lung cancer is a candidate for immunotherapy. Doctors consider several factors to decide whether this treatment may be helpful and safe for you.

Cancer type

Immunotherapy is most commonly used for:

• Non-small cell lung cancer (NSCLC)
• Small cell lung cancer (SCLC)

The specific subtype of lung cancer helps guide which immunotherapy drugs may be effective.

Stage of cancer

Immunotherapy may be used at different stages of lung cancer. In some cases, it is used for advanced or metastatic disease. In other cases, it may be combined with surgery, chemotherapy, or radiation for earlier stages.

The stage helps determine timing and whether immunotherapy is used alone or with other treatments.

Other factors doctors consider

Your care team also looks at:

• Results of tumor testing and biomarkers
• Your overall health and medical history
• How well your immune system is functioning
• Previous cancer treatments and how you responded to them

When immunotherapy may not be recommended

Immunotherapy may be used with caution or avoided in some situations, such as:

• Certain autoimmune conditions, where the immune system already attacks the body
• A history of severe immune-related reactions
• Organ transplants, where immunotherapy could increase the risk of rejection
• Specific health conditions that make side effects harder to manage

Your oncology team will review all of these factors with you and explain whether immunotherapy is an option, how it fits into your treatment plan, and what alternatives may be available.

Kinds of lung cancer immunotherapy

Immune checkpoint inhibitors

Your immune cells patrol your body for threats, including bacteria, viruses, and even cancer cells. When they identify a threat, they attack it. One of the ways your immune cells distinguish healthy cells from threats is by recognizing specific proteins—called immune checkpoints—on the healthy cells' surface. Unfortunately, lung cancer cells may mimic those immune checkpoints and trick your immune system.

Immune checkpoint inhibitors are a form of immunotherapy for lung cancer that block the interaction between immune cells and cancer cells displaying the immune checkpoints. As a result, the immune system can identify the cancer cell as a threat and attack it.

T-cell immunotherapy treatments for lung cancer

If your care team decides immunotherapy is a good option for you, another approach they may use is to modify or increase the immune cells in your body.

In CAR T-cell therapy, doctors:

1. Take a blood sample
2. Remove immune cells from it
3. Modify those immune cells so that they work more effectively
4. Re-introduce the modified cells to your body so they can target cancer

What to expect during immunotherapy treatment

• Immunotherapy is usually given through an IV at regular intervals, such as every few weeks.
• Treatment schedules vary depending on the medication and your specific care plan. Most appointments take a few hours, and many patients are able to go home the same day.
• Your care team will monitor how your body responds and adjust treatment as needed.

Daily life during treatment

Many people are able to continue their normal daily activities during immunotherapy, including work and light exercise. Some patients experience side effects such as fatigue, skin changes, or flu-like symptoms, which can affect energy levels from day to day.

Your care team will help you manage side effects and let you know when to rest, when to stay active, and when to call with concerns.

FAQs about immunotherapy for lung cancer