Lung cancer, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), can feel overwhelming, but immunotherapy is bringing fresh hope. This treatment uses your body’s immune system to target and destroy cancer cells, often with impressive results. Rainbow Cancer Research is advancing this field with trials combining a new checkpoint inhibitor, Domvanalimab, with the standard immunotherapy drug Durvalumab for patients with unresectable, locally advanced (stage III) NSCLC—both squamous and non-squamous types. Let’s explore how this works.
What Is Immunotherapy?
Immunotherapy boosts your immune system—your body’s natural defense—to better recognize and attack cancer cells. Normally, your immune system fights infections, but cancer cells can hide or trick it into ignoring them. Immunotherapy steps in to wake up or strengthen your immune response, helping it spot and eliminate lung cancer cells. Unlike chemotherapy or radiation, which attack cancer directly, immunotherapy partners with your body, offering a sense of empowerment.
How Does It Work for Lung Cancer?
The leading type of immunotherapy for lung cancer is checkpoint inhibitors. These drugs block proteins like PD-1, PD-L1, or CTLA-4 that cancer cells use to evade detection. By disabling these “shields,” the drugs free up immune cells (like T-cells) to attack the cancer—like unmasking a hidden enemy. Other approaches, such as cancer vaccines and CAR T-cell therapy, are under study, but checkpoint inhibitors remain the most established and widely approved option so far.
Which Types of Lung Cancer Benefit?
Immunotherapy has transformed treatment for both NSCLC (about 85% of lung cancers) and SCLC (a faster-growing type, about 15%). Here’s how:
- Non-Small Cell Lung Cancer (NSCLC): This includes subtypes like adenocarcinoma and squamous cell carcinoma. Immunotherapy shines in:
- Advanced or metastatic NSCLC: When surgery isn’t an option and cancer has spread, checkpoint inhibitors are common, especially if tumors show high PD-L1 levels (a marker of potential success). It’s used after chemo or as a first-line option with chemo.
- Early-stage NSCLC: For stages IB to IIIA after surgery or radiation, drugs like durvalumab or pembrolizumab help prevent recurrence.
- EGFR-mutant, ALK-positive, or similar NSCLC: These are typically treated with targeted therapies specific to the mutation, not immunotherapy.
- Small Cell Lung Cancer (SCLC): This aggressive type benefits too:
- Extensive-stage SCLC: When cancer spreads widely, drugs like durvalumab or atezolizumab pair with chemo to extend survival as a first-line treatment.
- Limited-stage SCLC: Less commonly, immunotherapy follows chemo and radiation to reduce recurrence risk.
Key Immunotherapy Drugs for Lung Cancer – Several drugs are approved or in trials for NSCLC and SCLC:
- Pembrolizumab (Keytruda): Targets PD-1. It’s a go-to for advanced NSCLC with high PD-L1 (≥50%) or with chemo for lower levels. For extensive-stage SCLC, it pairs with chemo. Studies like KEYNOTE-024 show it can add years to survival.
- Nivolumab (Opdivo): Also targets PD-1. Used post-chemo for advanced NSCLC or with ipilimumab for SCLC. The CheckMate 227 trial highlights its success in NSCLC with high tumor mutation burden.
- Atezolizumab (Tecentriq): Targets PD-L1. Approved for advanced NSCLC (solo or with chemo) and extensive-stage SCLC (with chemo). The IMpower150 trial confirms its value.
- Durvalumab (Imfinzi): Targets PD-L1. Used after chemo and radiation for stage III NSCLC or limited-stage SCLC to prevent recurrence. The PACIFIC trial cut recurrence risk by 32% in NSCLC.
- Ipilimumab (Yervoy): Targets CTLA-4. Often combined with nivolumab to amplify the immune response in NSCLC and SCLC.
These are typically given via IV every 2–6 weeks, continuing up to 2 years if effective and tolerable.
What Are the Benefits – Immunotherapy offers real advantages:
- It can extend survival—sometimes by months or years—beyond what chemo alone achieves.
- Side effects are often milder than chemo (less nausea or hair loss), though fatigue, rashes, or rare organ inflammation can occur.
- Some patients see lasting results, with tumors shrinking or vanishing, a big win for a tough disease.
What Are the Side Effects? Side effects are usually manageable with your care team’s support. Common ones include:
- Fatigue
- Skin rashes or itching
- Diarrhea or nausea
- Joint or muscle pain
- Rarely, severe inflammation in organs like the lungs or liver (monitored closely)
These may appear during treatment, soon after, or months later. Most resolve naturally or with treatment, but always report new symptoms to your doctor.
In Summary
Lung cancer is tough, but immunotherapy is a game-changer for NSCLC and SCLC, from early to metastatic stages. Your doctor will assess your cancer type, stage, PD-L1 levels, mutations (like EGFR or ALK), and health to see if it’s right for you. Clinical trials, like those combining immunotherapy with targeted therapies or radiation, are pushing boundaries further.
Rainbow Cancer Research is testing Domvanalimab with Durvalumab for unresectable stage III NSCLC. For stage IV, Rainbow Oncology Research compares Volrustoming (a new dual checkpoint inhibitor) to pembrolizumab and chemo as a first-line option.
For more, visit the Rainbow Oncology or Rainbow Research or contact us via email or phone.
http://www.oncorainbowresearch.com
You’re not alone—your care team and ongoing research are here for you.