Immunotherapy for Lung Cancer? An Expert Weighs In [Q&A]

Advanced lung cancer can be tough to beat. You might need chemotherapy, surgery, radiation, or some combination of treatments. Facing cancer and the road to recovery can feel overwhelming.

Immunotherapy offers new hope for patients with certain types of lung cancer, including non-small cell lung cancer (NSCLC). These drugs boost your immune system’s ability to spot and destroy cancer cells. The result is powerful. People with advanced lung cancer can live months, even years, longer than in the past.

What is this treatment like? And who is it good for? Richard Hall, MD, a lung cancer specialist at UVA Cancer Center, answers a few questions about this promising treatment.

What type of lung cancer patient can have immunotherapy?

We use it mostly for patients with advanced lung cancer – what we call stage 4, or metastatic lung cancer. In those situations, we may give immunotherapy by itself or in combination with other medicines, such as chemotherapy (before or after surgery).

Is immunotherapy good for any cancer type, stage, or genetic profile?

Immunotherapy isn’t right for every patient or every type of cancer.

Certain medical conditions, such as autoimmune diseases, can make it unsafe to get immunotherapy. We carefully evaluate every patient who could get immunotherapy to make sure it’s safe for them.

What is immunotherapy like for lung cancer patients?

Immunotherapy is typically given by intravenous (IV, meaning through your blood vessels) infusion at an infusion center. Infusion may take about 30 to 60 minutes.

This type of therapy ramps up your immune system. It can cause some side effects, such as rash, low thyroid levels, or swelling in your intestines or lungs.

Does immunotherapy need to be taken along with chemotherapy?

Our cancer team looks at the tumor under a microscope and decides if immunotherapy should be given alone or with other drugs (like chemotherapy).

We base our decision on the results of large clinical trials. This research helps us know what treatments work best for specific types of tumors. That way, you’ll get the best chances of survival.

Can immunotherapy offer a cure for some lung cancer patients?

The term “cure” has a lot of emotion associated with it. In larger studies, we’ve seen that up to 40% of patients with specific types of non-small cell lung cancer may have long-term remission. (Remission means the cancer is gone, but it may still return.)

This is based on certain tumor factors. Tumors with a high amount of a protein called PDL1 often survive for anywhere from 2 to 5 years. So I would say some patients can experience a cure or long-term remission when they receive immunotherapy.

Unfortunately, it’s not as many patients as we’d like. We have a lot of work to do to make that better.

When immunotherapy doesn’t work, is there something else that you can use in its place?

We always have a discussion with each patient about their goals and what’s important to them. We look at potential side effects. If immunotherapy doesn’t work or isn’t an option, we’re always looking for new treatments through clinical trials.