Lung Cancer Immunotherapy in Delhi | Treatment of Stage 4 lung cancer | Cancer Immunotherapy in India
A revolution is occurring in the treatment of stage 4 lung cancer – the rapid development of lung cancer immunotherapy in Delhi.
Immunotherapy has revolutionized the treatment of cancer
For decades, the only treatment options for stage 4 lung cancer was chemotherapy. While chemotherapy is very useful in the treatment of stage 4 lung cancer, it suffers from many problems:
- The benefit of chemotherapy is limited – only about 30% of patients will respond to chemotherapy alone
- The duration of benefit from chemotherapy is limited – usually lasting only a few months
- While chemotherapy is safe in expert hands, it often leads to side-effects which many patients would prefer to avoid
However, a silent revolution has been occurring in the background – the advent of lung cancer immunotherapy.
Mechanism of immunotherapy for treatment of stage 4 lung cancer
Cancer Immunotherapy refers to use of the body’s own immune system to fight cancer. Immune system refers to the natural defenses of the body against diseases. For instance, if a bacteria enters the blood stream, it is killed by cells from the Immune system.
The ability of the immune system to fight cancer can be “boosted” using various technologies. This field of anticancer therapy is called “cancer immunotherapy”.
Hindi video introduction to lung cancer immunotherapy
Which stage 4 lung cancer patients benefit from immunotherapy?
Lung cancer subgroups
Around 25-30% of stage 4 lung cancers can be treated with targeted therapy. The remaining 70-75% are called “mutation-negative lung cancers”. The traditional treatment option for these patients has been chemotherapy.
In a series of recent studies, it has been found that use of immunotherapy in these patients can result in a dramatic improvement of survival of these patients.
Learn more about targeted therapy
Benefits among patients with stage 4 lung cancer
In the KEYNOTE-024 study, patients with mutation-negative stage 4 lung cancer lacking certain mutations were divided into two groups – one group was treated with chemotherapy and the other with immunotherapy.
It soon became apparent that immunotherapy is much more effective than chemotherapy. The average survival of patients receiving immunotherapy was more than double as compared to those who received chemotherapy. At the same time, the risk of serious side effects was almost half in the immunotherapy arm compared to the chemotherapy arm.
Average survival of patients in KEYNOTE 024
Grade 3 or higher toxicity in KEYNOTE 024 study
Chemotherapy-immunotherapy combinations
KEYNOTE-189 study: A recent study conducted in patients with stage 4 lung cancer compared chemotherapy alone with a chemotherapy-immunotherapy combination. Again, a dramatic improvement in survival has been noted with only a minor increase in side-effects. Patients receiving immunotherapy had around half the risk of death as compared to patients receiving chemotherapy alone.
There was an impressive difference in survival with immunotherapy
Similar benefits have been seen with other chemotherapy-immunotherapy combination as well.
Can immunotherapy “cure” stage 4 lung cancer?
One interesting thing about immunotherapy is that a small percentage of stage 4 cancer patients can obtain very long lasting (durable) control of tumor. While the word “cure” may or may not be appropriate, research has shown that a subset of patients achieves excellent long-term disease control. This data is most mature for cancers like melanoma (skin cancer).
Dramatic improvements in the outcome of stage 4 melanoma with immunotherapy seen in some studies
Analysis of lung cancer data presented recently shows that a subset of patients remain alive even beyond 5 years without further treatment. While the data in lung cancer is still early at the present time, evidence strongly indicates that a proportion of patients will achieve a long-term remissions that are maintained without treatment, a situation that basically means cure.
Learn more about immunotherapy in cancer (Hindi video)
Is immunotherapy dangerous?
While immunotherapy can be very effective in treating cancer, it also has a small risk of serious side effects. Since these drugs activate the immune system, normal organs may get damaged by excessive immune activation. Therefore, it is necessary to follow the oncologist’s instructions very carefully while on immunotherapy, to be alert for any side effects and to follow the surveillance schedule very very carefully.
A detailed patient guide to immunotherapy side-effects is available here
Is lung cancer immunotherapy available in Delhi/India?
Yes. Checkpoint inhibitors have recently become available in Delhi and India.
Delhi is one of the cities on the cutting edge of cancer treatment and several state-of-the-art cancer facilities are available here. Dr Vineet Govinda Gupta is a board certified medical oncologist, formerly at AIIMS New Delhi with expertise in safe and potent cancer immunotherapy in lung cancer. More details here.
Conclusion
Lung cancer immunotherapy has led to a dramatic improvement in survival in stage 4 lung cancer patients who do not have the option of targeted therapy. It is now a mainstream treatment option for lung cancer, and ideally used in the first-line setting!
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- Information about cancer
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- Learn more about cure rates of common cancers
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