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Q&A: Immunotherapy and Future Options in Lung Cancer

Published on April 8, 2016

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Question from Caroline:  Is there a maximum amount of time to stay on immunotherapy or are there other options I should still be looking into? 

Answers from Dr. Rebecca Heist and Dr. George Simon: 

Dr. Heist:                  

It can last for a long time. And I typically don’t take people off of it if they’re doing well on it.  It is an area of research. So we don’t quite know.  And there are some immunotherapies where it may be that, if you take people off, they will actually remain without evidence of disease.  But we don’t quite know yet. And for the PD1 inhibitors, the general thought is that you have to stay on it.  So I would stay on it for as long as it’s working. Should you be looking at other things? I think it’s always worth being forward-thinking. But I wouldn’t change anything if it’s working.

So if something is working well for you, and you’re tolerating it well, that’s not the time to be looking to switch therapy. That’s the time to be just doing the therapy you’re doing and enjoying the fact that there’s not much activity in terms of change to think about.  So there is a little element of if it ain’t broke, don’t fix it.

But I think it is worth doing what you’re doing, which is looking to see what else is out there so that whenever the time is that I need something else, I actually know what the lay of the land is so I can be thinking about what might be next.

Andrew Schorr:       

Dr. Simon, related to what could be next, some people have seen news reports, even whether it goes back a couple of years or even a couple of days, on making an anti-cancer vaccine out of your own—some people saw it on the news, right, from your own cells. And then boosting those cells like taking them to the gym in a Petri dish or something, infuse them back in where they could fight your cancer better than ever before.  That’s not here yet.  But for somebody who is living now and doing well, could that be next? 

Dr. Simon:               

So it’s investigational.  And there are centers around the country, particularly NCI, that are taking out certain kinds of immune antigen-presenting cells, growing them ex vivo, outside the patient’s body, exposing them to tumor antigens, and putting them back in.

Now these techniques are very resource intense and expensive and investigational and are being evaluated in the context of a clinical trial but not available as a standard of care. So I think it’s worth investigating. I worry about its scalability.  That means you have to develop a treatment that can be widely applied across the country and not in a couple of centers. But these are investigational and currently being studied. But we have to still see more mature data.

Andrew Schorr:       

But the idea is still can we do something with the immune system to fight the cancer? That’s the big idea, right?

Dr. Simon:               

That is the idea.  In a sense, it is trying to teach the immune system to identify antigens or proteins that are found only on the surface of the tumor cell.  And that’s the idea. And people are looking at those approaches in conjunction with PD1 inhibitors. So there’s one antigen presentation component, and then there is one unharnessed in the immune system component.  And so people are studying some vaccines in conjunction with PD1 inhibitors. 

Andrew Schorr:       

So for the lady there who is on immunotherapy, like a PD1 inhibitor, I assume, then it could be that, down the road, there could be some kind of would it be like a shot that you get, like a flu shot? 

Dr. Simon:               

Yes.  So it’s a subcutaneous injection under the skin. And, typically, some of them are infusions. And they may have to be repeated every two or three times every six weeks or three months. 

Andrew Schorr:       

But not ready for prime time yet.

Dr. Simon:               

Not ready for prime time.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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The University of Texas MD Anderson Cancer Center LUNGevity Foundation

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