Lung cancer is the leading cause of cancer-related mortality worldwide. According to the latest Globocan data 2018, there are 67,795 new cases of lung cancer which comprises around 5.9 percent of all cancer types in India . The incidence is higher in males with 38,687 new patient cases in 2018 in India comprising 8.5% of all cancer types .
It is the 4th most common cancer in India and the 3rd largest reason for cancer related deaths . Targeted therapy in the form of monoclonal antibodies and tyrosine kinases inhibitors have redefined treatment options for patients with Lung Cancer with mutations (e.g., epidermal growth factor receptor [EGFR]-mutant, anaplastic lymphoma kinase [ALK]-rearranged NSCLC). However, majority of the patients lack such genetic alterations; in whom these therapies are ineffective. Immunotherapy has become an integral part of the treatment for these patients and has led to improvements in survival and quality of life.
Immunotherapy in Lung Cancer: A Promising and Revolutionary Recourse
Immunotherapy is a type of treatment that uses the body’s immune system to help slow or stop cancer growth. Various forms of immunotherapy are being developed to help the body recognize a tumor as being different from normal tissues in the body. One of these immunotherapy approaches is a group of medications called checkpoint inhibitors. “Checkpoints” are a built-in part of the immune system intended to prevent it from attacking healthy cells. Checkpoint inhibitors act on the body’s lymphocytes (a type of white blood cell normally involved in fighting infections) to allow them to identify and destroy cancer cells.
There are currently 3 Immunotherapy drugs approved for treatment of Carcinoma of lung. These drugs are given through Intravenous route every 2-3 weekly. These drugs are highly effective if given to an appropriate selected advanced lung cancer. These drugs have not only increased the response rates but have also prolonged life in advanced cancer patients. Although uncommon these drugs can sometimes keep the disease in control for very long time.
The side effects of immunotherapy are related to its actions that allow the immune system to attack cancerous tissue. This can affect normal (healthy) tissue as well; as a result, a variety of side effects can occur, including skin reactions, colitis (inflammation of the colon), pneumonitis (inflammation of the lungs), and endocrine disorders such as thyroid disease. However all the above side effects are not so common and the side effects are much lesser then chemotherapy. In future Immunotherapy drugs will be combined with chemotherapy and radiation therapy for better disease control with the availability of these drugs. There is a new weapon in the armamentarium to fight lung cancer. However these drugs are currently costly because of new technology patents and are not assessable to many in our country.
These drugs do offer a new ray of hope to advance lung cancer patients.