*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.

Immunotherapy is a type of cancer treatment that uses the body's immune system to fight cancer.

Unlike chemotherapy, immunotherapy does not attack cancer cells directly. Instead, it stimulates your immune system to recognize and attack the cancer cells.

Immunotherapy is a kind of precision medicine.
Precision medicine means treatment that is tailored to the precise features of your cancer.

The immune system’s job is to fight off infections and foreign invaders that can make you sick. But it needs help to fight cancer because cancer cells find ways to hide from the immune system.

Immunotherapy means giving drugs that strengthen the immune system so it can attack cancer cells more effectively.

The role of immunotherapy in treating your lung cancer will depend, in part, on the type of lung cancer you have.

Lung cancer is classified into two main types, based on how the tumor cells look under a microscope.

Non-small cell lung cancer, or NSCLC, is by far the most common type of lung cancer. Out of every 10 patients with lung cancer, around eight or nine have non-small cell lung cancer.

The other main type of lung cancer is called small cell lung cancer, or SCLC. Around one or two out of every 10 patients with lung cancer have small cell lung cancer.

The immunotherapy drugs that are most often used to treat both NSCLC and SCLC are called "checkpoint inhibitors."

On the surface of cancer cells there are proteins that “put the brakes” on the immune system. They serve as “checkpoints” that stop the immune system from launching an all-out assault on cancer.

Checkpoint inhibitors work by “taking off the brakes” and giving the immune system free rein to release special cells called T cells that attack the cancer.

Several checkpoint inhibitors have been approved to treat lung cancer that has metastasized, or spread, into the chest, to lymph nodes near the lungs, or from the lungs to other organs

These drugs work by blocking checkpoint proteins called PD-1, PD-L1, or CTLA-4.

Some patients with advanced lung cancer respond well to immunotherapy, while others do not.

Doctors don’t yet fully understand why some patients respond well to immunotherapy and others don’t.

Some immunotherapy drugs are approved to be given with chemotherapy.

Studies are under way to test whether giving two immunotherapy drugs together is more effective than a single drug for patients with advanced lung cancer.

Side effects can occur when an immunotherapy drug attacks healthy cells. Common side effects include

• Feeling tired and weak
• Pain in the muscles, joints, or stomach
• Loss of appetite
• Itching
• Diarrhea
• Skin rash

Your health care team can help you manage the side effects of your treatment. Be sure to talk to them about any side effects you're having.

References

1. Brahmer J et al. The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of non-small cell lung cancer (NSCLC). Journal for ImmunoTherapy of Cancer (2018) 6:75.
2. Gubens M & Davies M. NCCN Guidelines Updates: New Immunotherapy Strategies for Improving Outcomes in Non–Small Cell Lung Cancer. J Natl Compr Canc Netw 2019;17(5.5):574-578.
3. Kalemkerian GP et al. NCCN Guidelines® Insights Small Cell Lung Cancer, Version 2.2018 Featured Updates to the NCCN Guidelines. J Natl Compr Canc Netw 2018;16(10):1171–1182.
4. Lung Cancer Research Foundation. Immunotherapy for the Treatment of Lung Cancer. 2019. http://b2b.suttle-straus.com/C/lcrf/immunotherapy-for-the-treatment-of-lung-cancer-plus-insert-4.
5. National Cancer Institute. Atezolizumab. 6/8/2020. https://www.cancer.gov/about-cancer/treatment/drugs/atezolizumab.
6. National Cancer Institute. Durvalumab. 3/30/2020. https://www.cancer.gov/about-cancer/treatment/drugs/durvalumab.
7. National Cancer Institute. Nivolumab. 6/17/2020. https://www.cancer.gov/about-cancer/treatment/drugs/nivolumab.
8. National Cancer Institute. Pembrolizumab. 7/9/2020. https://www.cancer.gov/about-cancer/treatment/drugs/pembrolizumab.
9. Patel J. Just Diagnosed With Lung Cancer: Answers from an Expert. 7/14/2018. https://www.cancer.net/blog/2018-06/just-diagnosed-with-lung-cancer-answers-expert.