Immunotherapy is indeed available for lung cancer and has become a significant advancement in its treatment, especially over the past decade. It works by harnessing the body’s own immune system to recognize and attack cancer cells more effectively. This approach differs from traditional treatments like chemotherapy or radiation, which directly target cancer cells but can also harm healthy cells.
Lung cancer primarily comes in two main types: non-small cell lung cancer (NSCLC), which accounts for about 80-85% of cases, and small cell lung cancer (SCLC). Immunotherapy is used in both types but with some differences depending on the stage of the disease and specific characteristics of the tumor.
For **non-small cell lung cancer**, immunotherapy often involves drugs called immune checkpoint inhibitors. These drugs target proteins such as PD-1, PD-L1, or CTLA-4 that normally act as “brakes” on immune cells called T-cells. Cancer cells exploit these checkpoints to avoid being attacked by the immune system. By blocking these checkpoint proteins, immunotherapy “releases the brakes,” allowing T-cells to identify and destroy lung cancer cells more aggressively.
Immunotherapy can be used at various stages of NSCLC:
– In *advanced or metastatic* NSCLC where surgery isn’t an option, immunotherapy may be given alone or combined with chemotherapy to improve survival.
– For *early-stage* resectable NSCLC (where surgery is possible), immunotherapy may be administered before surgery (neoadjuvant) or after surgery (adjuvant) alongside chemotherapy to reduce recurrence risk by eliminating microscopic disease that might remain after tumor removal.
Doctors usually perform biomarker testing on tumors before deciding if immunotherapy is suitable because certain markers like PD-L1 expression levels help predict how well a patient might respond. Patients whose tumors express higher levels of PD-L1 tend to benefit more from checkpoint inhibitors.
In terms of **small cell lung cancer**, which tends to grow faster and spread earlier than NSCLC, immunotherapy has also made important strides recently. For extensive-stage SCLC—where the disease has spread widely—immunotherapy combined with chemotherapy has become a standard first-line treatment option because it improves survival compared to chemotherapy alone.
A newer type of immunotherapy called bispecific T-cell engagers (BiTEs), such as tarlatamab targeting DLL3 protein on SCLC cells while activating T-cells simultaneously, shows promise in clinical trials for patients whose disease relapses after initial therapy.
While many patients tolerate immunotherapies well with mild side effects like fatigue or skin rash, there are risks since boosting immune activity can sometimes cause it to attack normal tissues leading to inflammation in organs such as lungs (pneumonitis), liver (hepatitis), intestines (colitis), or endocrine glands causing hormonal imbalances. Close monitoring by healthcare teams helps manage these potential complications promptly.
Overall, **immunotherapy represents a revolutionary shift** in treating lung cancers by offering new hope beyond conventional therapies through personalized approaches tailored according to tumor biology and patient factors. Ongoing research continues exploring combinations of different immunotherapies with chemo-, targeted therapies or novel agents aiming at improving response rates further while minimizing side effects across all stages and subtypes of lung cancer worldwide.
