Immunotherapy Update in Lung Cancer

Written by Dr Iseult Browne, Oncology Specialist Registrar and Dr Mark Doherty, Consultant Medical Oncologist, St Vincent’s University Hospital

Lung cancer is the fourth most common type in Ireland. Roughly 2749 people are diagnosed annually.

Patients over the age of 50 are majority those diagnosed. Less than 1% occurring before the age of 40.

There are two main types of lung cancer

Non-small cell lung cancer (NSCLC) accounts for 80%–90% of lung cancers. Small cell lung cancer (SCLC) has been decreasing in frequency in many countries over the past two decades.

The staging determines the treatment goal and overall survival rate (OS). Ranging from a 6% 5 year OS in stage 4 disease to 35% in stage 1 disease. Rates are continuing to improve with new advances in systemic treatment such as immunotherapy and targeted drugs.

Until 2015 the mainstay of systemic treatment in Ireland for the management of lung cancer was chemotherapy. It was either on its own or in combination with radiotherapy depending on the treatment plan decided.

The treatment of patients with the disease has undergone a transformational change in the past decade and long-term results with immunotherapy agents and targeted therapies are providing the hope of long term survival for a substantial number of patients even with advanced disease.

Selection of appropriate patients for treatment is vital, with the requirement to find additional biomarkers to enrich patient populations for response.

Although the toxicity profile is different than conventional chemotherapy, patients must be educated on early detection and prompt action when toxicity occurs.

While there have been major advances in the treatment in the past decade, there remains a need to improve outcomes for the patients with lung cancer who do not experience durable survival, and this research is ongoing.

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