A Growing Number Of Lung Cancer Patients Are Benefiting From Immunotherapy
Laurie Luteran, BSN, RN, OCN
Oncology Patient Navigator, Nancy N. & J.C. Lewis Cancer & Research Pavilion
Smart Living: As a patient navigator, you help guide lung cancer patients through their continuum of care. Have you seen any developments in treatment that may benefit patients?
Laurie Luteran: Immunotherapy is an exciting and fairly recent development in the treatment of non-small cell lung cancer. There are two types of lung cancer—small cell and non-small cell—but non-small cell lung cancer is far more common, accounting for about 85 percent of all primary lung cancers. Unfortunately, at the time of diagnosis, most patients present with advanced disease that cannot be surgically removed. For a long time, chemotherapy was the only systemic treatment available to prolong survival, but immunotherapy has emerged as a treatment option for certain patients.
Unlike chemo, immunotherapy is designed to make use of the body’s own immune system to fight cancer. Typically, your immune system works to defend your body against infections and cancer cells. Sometimes cancer cells avoid this by making what’s called a checkpoint protein, PD-L1, which works as a kind of blindfold, so to speak. It binds to T-cells, a type of white blood cell, making them unable to see the cancer cells. Checkpoint inhibitor immunotherapies work in turn by either binding to proteins on the T-cells or binding to proteins on the cancer cells themselves. In either case, this binding of proteins removes the blindfold, allowing T-cells to recognize and destroy the cancer.
SL: How do lung cancer patients receive immunotherapy? Is it similar to chemo?
LL: It’s similar in that the patient sits in a chair and the immunotherapy drug is administered through a vein in the arm or a port implanted in the chest. The treatment time varies with the type of drug, but typically patients will need a 30 to 60 minute infusion every two or three weeks. Generally, immunotherapy is well-tolerated by patients, but as with any drug, side effects may occur. Mild side effects include fatigue, muscle or joint pain, or itching. In some instances, more serious side effects can occur.
Not all patients are eligible for immunotherapy. Testing is done on a patient’s tumor to determine how likely he or she will respond to this treatment. As an oncology patient navigator, it has been very exciting for me to see these advances develop. Researchers continue to determine which patients are most likely to benefit, and more indications are being approved all the time.