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Supported by an educational grant from Merck.

October 2016

Immunotherapy drugs for lung cancer activate the immune system to help your body recognize the cancer as harmful so your body can fight it.

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T T cells
C Cancer cells

Your immune system uses different ways to talk to other cells to gather information about whether to attack an invader or leave it alone.

One way your immune system communicates is through connections between molecules on the surface of immune cells (like T lymphocyte cells also known as T cells) and foreign cells (like cancer cells).

T T cells
C Cancer cells

Cancer cells have found ways to keep the immune system from destroying them. One way some cancer cells do this is by producing a protein called PD‑L1. This protein binds to PD‑1 receptors on T cells and turns them off. This prevents them from killing the cancer cell.

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Cancer
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PD-1

Current FDA-approved lung cancer immunotherapy drugs work to stop the cancer cells from turning off the T cells. Approved drugs either target the PD-L1 protein or the PD-1 receptor. No matter which they target, they have the same goal of blocking or "inhibiting" the contact between the PDL-1 protein and the PD-1 receptor on the T cell.

This re-activates the T cells and turns the immune system back on, helping it fight the cancer. There are other drugs in immunotherapy clinical trials for lung cancer that address other pathways in the immune system.

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These drugs are given through an IV into your veins called an infusion. Patients get infusions every few weeks. Most patients stay on immunotherapy for several months. Some patients may stay on for longer or shorter periods of time, depending on their side effects.

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Immunotherapy is different from other lung cancer treatments in some important ways. Choose one of the circles to learn more.

Chemotherapy Traditional chemotherapy uses chemicals to kill or damage cells. These drugs can affect healthy cells too.
Targeted therapy Targeted therapy is a type of precision medicine. It focuses on addressing specific mutations that are in some lung cancer tumors.
Radiation Radiation therapy uses powerful, high-energy X-rays to kill cancer cells or keep tumors from growing.
Immunotherapy Immunotherapy is another type of precision medicine. It targets the communication between the immune system and the tumor to help the immune system fight the cancer.

Use the puzzle pieces to learn more.

Current FDA-approved immunotherapy drugs are for patients with advanced non-small cell lung cancer.
There are more options within immunotherapy than ever before. There are first-line, second-line and combination treatments available.
Before trying immunotherapy, your doctor may also want to test your tumor to see if it contains PD-L1. This may help predict how you will respond to immunotherapy, and the best drug choice for you.
Certain health conditions, such as autoimmune diseases like lupus or rheumatoid arthritis, might make it unsafe for you to be on immunotherapy.

Some of the most common side effects of immunotherapy drugs are:

Immunotherapy can cause inflammation in the organs of the body. Inflammation can happen in any organ including: lung (pneumonitis), liver (hepatitis), colon (colitis/diarrhea) or thyroid gland. This can be very serious, and all possible side effects should be discussed with your doctor before you begin the drug.

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It is best to work very closely with your doctors and nurses to manage your side effects. Some side effects can be treated with over-the-counter medication. Other side effects may require prescription drugs or even time spent in the hospital. If side effects are managed early, it is easier to avoid major problems, and you may be able to stay on the immunotherapy medication longer.

Ask about being connected with a palliative care team to help you manage your side effects and maintain a good quality of life.

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Am I eligible for an approved lung cancer immunotherapy drug?

There are several FDA-approved lung cancer immunotherapy drugs for patients with advanced stage non-small cell lung cancer. There are more options within immunotherapy than ever before. There are now first-line, second-line and combination immunotherapy treatments available. Each drug has specific indications based upon the type of lung cancer you have, whether or not you have any mutations or biomarkers, what treatment (if any) you have tried in the past and your general health. Work with your doctor to understand your options.

Is a lung cancer immunotherapy clinical trial right for me?

There are promising lung cancer immunotherapy treatments being studied in clinical trials. Ask your doctor if any ongoing trials are the right treatment option for you.

How can we work together to manage my side effects?

Many people on immunotherapy report fewer side effects than traditional chemotherapy. However, there can be some very serious side effects associated with immunotherapy, like inflammation of the organs. Close monitoring is important. Ask your doctor what signs and symptoms you should watch for and what to do.

Will it work for me?

Some patients respond very well to immunotherapy, while others do not have the same positive result. No one can predict how your body will respond to any one treatment. Work with your doctor to understand what you can expect while on an immunotherapy drug, and if it is the right choice for you.

Immunotherapy is a rapidly advancing field of lung cancer treatment. For the latest immunotherapy news, visit Lung.org/immunotherapy.

Supported by an educational grant from Merck.

October 2016
What is it? Who is eligible? What are the side effects? Questions for your doctor
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