绿帽社

Immunotherapy is the use of medicines to help a person’s own immune system to recognize and destroy cancer cells more effectively.

Immune checkpoint inhibitors

An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses “checkpoint” proteins on immune cells, which act like switches that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system.

Drugs that target these checkpoints (called checkpoint inhibitors) can be used to treat some people with non-small cell lung cancer (NSCLC).

PD-1/PD-L1 inhibitors

Nivolumab (Opdivo), pembrolizumab (Keytruda), and cemiplimab (Libtayo) target PD-1, a protein on certain immune cells (called T cells) that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

Atezolizumab (Tecentriq) and durvalumab (Imfinzi) target PD-L1, a protein related to PD-1 that is found on some tumor cells and immune cells. Blocking this protein can help boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

These drugs can be used in different situations to treat NSCLC. In some cases, before one of these drugs can be used, lab tests might need to be done on the cancer cells to show they have at least a certain amount of the PD-L1 protein (which would mean these drugs are more likely to work) and if the cancer cells have “driver mutations.” Depending on the results of those lab tests and the stage of lung cancer, the PD-1/PD-L1 inhibitors can be used in different ways. They can be given with or without chemotherapy, with or without a CTLA-4 inhibitor (see below), before or after surgery for early-stage lung cancer, or for a long period of time for advanced-stage lung cancers.

All of these drugs can be given as intravenous (IV) infusions. Atezolizumab (as Tecentriq Hybreza) and nivolumab (as Opdivo Qvantig) can also be given as an injection under the skin (subcutaneously) over several minutes. Depending on the drug, they might be given every 2, 3, 4, or 6 weeks.

Possible side effects

Side effects of these drugs can include fatigue, cough, nausea, itching, skin rash, loss of appetite, constipation, joint pain, and diarrhea.

Other, more serious side effects occur less often.

Infusion reactions: Some people might have an infusion reaction while getting these drugs. This is like an allergic reaction, and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It’s important to tell your cancer care team right away if you have any of these symptoms while getting these drugs.

Autoimmune reactions: These drugs work by removing one of the safeguards on the body’s immune system. Sometimes the immune system starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lun