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

Is immunotherapy the right treatment for your Small Cell Lung Cancer (SCLC)? The first step in finding out is for your doctor to do a complete evaluation. This will include tests to look for genetic changes and for the checkpoint protein PD-L1 in your tumors.

Your doctor will also consider other factors, such as

• The stage of your cancer. Staging is a way of measuring how much cancer is in your body.
• Whether you’ve been treated for small cell lung cancer before and what kind of treatment you received.

Your doctor may recommend immunotherapy if your cancer has spread

• widely in one lung,
• to the other lung,
• to lymph nodes near the lungs, or
• from the lungs to other organs.

If your cancer has spread in any of these ways, it is called extensive-stage small cell lung cancer.

If you have not been treated for small cell lung cancer before, your doctor may recommend that you start treatment with a combination of immunotherapy and chemotherapy drugs.

If your cancer has grown or come back after treatment, your doctor may recommend that you be treated with one immunotherapy drug or with a combination of two immunotherapy drugs.

Even if your cancer cells do not contain the checkpoint protein PD-L1, or have low levels of it, immunotherapy may still work for you after you have received other treatments.

Clinical trials are tests to find out if a new cancer treatment is better than existing treatments. Ask your doctor if enrolling in a clinical trial is right for you.

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

Always talk with your health care team about any side effects you are having.

Side effects of immunotherapy are often treated with drugs that suppress your immune system. Your immunotherapy will be stopped until the side effects clear up.

It’s important to discuss all of your treatment options as well as possible side effects with your health care team, so you can make decisions that are right for you. If there’s anything you don’t understand, ask to have it explained.

References

1. American Cancer Society. Immunotherapy for Small Cell Lung Cancer. Last Revised: March 31, 2020. https://www.cancer.org/cancer/lung-cancer/treating-small-cell/immunotherapy.html
2. American Cancer Society. Treatment Choices for Small Cell Lung Cancer, by Stage. Last Revised: March 31, 2020. https://www.cancer.org/cancer/lung-cancer/treating-small-cell/by-stage.html
3. Columbus G. Atezolizumab Triplet Approved by FDA for Frontline SCLC. Targeted Oncology. March 19, 2019. https://www.targetedonc.com/view/atezolizumab-triplet-approved-by-fda-for-frontline-sclc
4. Cooper MR, Alrajhi AM2, Durand CR. Role of Immune Checkpoint Inhibitors in Small Cell Lung Cancer. Am J Ther. 2018 May/Jun;25(3):e349-e356. https://www.ncbi.nlm.nih.gov/pubmed/29722737
5. Kalemkerian GP, Loo Jr BW, Akerley W, 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. doi: 10.6004/jnccn.2018.0079.
6. National Cancer Institute. Atezolizumab. 6/8/2020. https://www.cancer.gov/about-cancer/treatment/drugs/atezolizumab
7. National Cancer Institute. Durvalumab. 3/30/2020. https://www.cancer.gov/about-cancer/treatment/drugs/durvalumab
8. National Cancer Institute. Nivolumab. 6/17/2020. https://www.cancer.gov/about-cancer/treatment/drugs/nivolumab
9. National Cancer Institute. Pembrolizumab. 7/9/2020. https://www.cancer.gov/about-cancer/treatment/drugs/pembrolizumab
10. Postow M, Wolchok J. Special considerations and toxicities associated with checkpoint inhibitor immunotherapy. 2020. UpToDate, Inc. https://www.uptodate.com/contents/special-considerations-and-toxicities-associated-with-checkpoint-inhibitor-immunotherapy
11. Stenger M. Pembrolizumab in Metastatic Small Cell Lung Cancer. August 10, 2019. https://www.ascopost.com/issues/august-10-2019/pembrolizumab-in-metastatic-small-cell-lung-cancer/
12. Tam WW. Small Cell Lung Cancer (SCLC) Treatment & Management. Updated: Apr 03, 2020. https://emedicine.medscape.com/article/280104-treatment#d11