Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)
Is immunotherapy right for your SCLC? Evaluation
Is immunotherapy right for your SCLC? Staging, treatment history
Is immunotherapy right for your SCLC? Extensive-stage SCLC
When is immunotherapy right as a first treatment for extensive-stage SCLC?
When is immunotherapy right as a later treatment for extensive-stage SCLC?
What are clinical trials? Is a clinical trial right for me?
What side effects can occur from immunotherapy?
How are immunotherapy side effects treated?
Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)

*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.

Is immunotherapy right for your SCLC? Evaluation

Is immunotherapy the right treatment for your Small Cell Lung Cancer (SCLC)? The first step in finding out is for your doctor to do a complete evaluation. This will include tests to look for genetic changes and for the checkpoint protein PD-L1 in your tumors.

Is immunotherapy right for your SCLC? Staging, treatment history

Your doctor will also consider other factors, such as

  • The stage of your cancer. Staging is a way of measuring how much cancer is in your body.
  • Whether you’ve been treated for small cell lung cancer before and what kind of treatment you received.
Is immunotherapy right for your SCLC? Extensive-stage SCLC

Your doctor may recommend immunotherapy if your cancer has spread

  • widely in one lung,
  • to the other lung,
  • to lymph nodes near the lungs, or
  • from the lungs to other organs.

If your cancer has spread in any of these ways, it is called extensive-stage small cell lung cancer.

When is immunotherapy right as a first treatment for extensive-stage SCLC?

If you have not been treated for small cell lung cancer before, your doctor may recommend that you start treatment with a combination of immunotherapy and chemotherapy drugs.

When is immunotherapy right as a later treatment for extensive-stage SCLC?

If your cancer has grown or come back after treatment, your doctor may recommend that you be treated with one immunotherapy drug or with a combination of two immunotherapy drugs.

Even if your cancer cells do not contain the checkpoint protein PD-L1, or have low levels of it, immunotherapy may still work for you after you have received other treatments.

What are clinical trials? Is a clinical trial right for me?

Clinical trials are tests to find out if a new cancer treatment is better than existing treatments. Ask your doctor if enrolling in a clinical trial is right for you.

What side effects can occur from immunotherapy?

Side effects can occur when an immunotherapy drug attacks healthy cells. Common side effects include

  • Feeling tired and weak
  • Pain in the muscles, joints, or stomach
  • Loss of appetite
  • Itching
  • Diarrhea
  • Skin rash
How are immunotherapy side effects treated?

Always talk with your health care team about any side effects you are having.

Side effects of immunotherapy are often treated with drugs that suppress your immune system. Your immunotherapy will be stopped until the side effects clear up.

It’s important to discuss all of your treatment options as well as possible side effects with your health care team, so you can make decisions that are right for you. If there’s anything you don’t understand, ask to have it explained.

References

  1. American Cancer Society. Immunotherapy for Small Cell Lung Cancer. Last Revised: March 31, 2020. https://www.cancer.org/cancer/lung-cancer/treating-small-cell/immunotherapy.html
  2. American Cancer Society. Treatment Choices for Small Cell Lung Cancer, by Stage. Last Revised: March 31, 2020. https://www.cancer.org/cancer/lung-cancer/treating-small-cell/by-stage.html
  3. Columbus G. Atezolizumab Triplet Approved by FDA for Frontline SCLC. Targeted Oncology. March 19, 2019. https://www.targetedonc.com/view/atezolizumab-triplet-approved-by-fda-for-frontline-sclc
  4. Cooper MR, Alrajhi AM2, Durand CR. Role of Immune Checkpoint Inhibitors in Small Cell Lung Cancer. Am J Ther. 2018 May/Jun;25(3):e349-e356. https://www.ncbi.nlm.nih.gov/pubmed/29722737
  5. Kalemkerian GP, Loo Jr BW, Akerley W, et al. NCCN Guidelines® Insights Small Cell Lung Cancer, Version 2.2018 Featured Updates to the NCCN Guidelines. J Natl Compr Canc Netw 2018;16(10):1171–1182. doi: 10.6004/jnccn.2018.0079.
  6. National Cancer Institute. Atezolizumab. 6/8/2020. https://www.cancer.gov/about-cancer/treatment/drugs/atezolizumab
  7. National Cancer Institute. Durvalumab. 3/30/2020. https://www.cancer.gov/about-cancer/treatment/drugs/durvalumab
  8. National Cancer Institute. Nivolumab. 6/17/2020. https://www.cancer.gov/about-cancer/treatment/drugs/nivolumab
  9. National Cancer Institute. Pembrolizumab. 7/9/2020. https://www.cancer.gov/about-cancer/treatment/drugs/pembrolizumab
  10. Postow M, Wolchok J. Special considerations and toxicities associated with checkpoint inhibitor immunotherapy. 2020. UpToDate, Inc. https://www.uptodate.com/contents/special-considerations-and-toxicities-associated-with-checkpoint-inhibitor-immunotherapy
  11. Stenger M. Pembrolizumab in Metastatic Small Cell Lung Cancer. August 10, 2019. https://www.ascopost.com/issues/august-10-2019/pembrolizumab-in-metastatic-small-cell-lung-cancer/
  12. Tam WW. Small Cell Lung Cancer (SCLC) Treatment & Management. Updated: Apr 03, 2020. https://emedicine.medscape.com/article/280104-treatment#d11

Slide Show - Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)

This slide show provides an overview of several immunotherapy treatments that have been approved for small cell lung cancer (SCLC). Immunotherapy is the use of medicines to stimulate the body's immune system to recognize and attack cancer cells. This slide show also describes how your doctor will evaluate whether immunotherapy is right for you, possible treatment side effects, and clinical trials. It’s very important to report any side effects to your health care team promptly. Side effects of immunotherapy are often treated with drugs that suppress your immune system. Your immunotherapy will be stopped until the side effects clear up. Discuss all of your treatment options as with your health care team, so you can make decisions that are right for you. If there’s anything you don’t understand, ask to have it explained.

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