Written by MSD in the Philippines
What’s it going to be like?
Testing
In many cases of non-small cell lung cancers and gastric cancers, the first step is to undergo PD- L1 testing for the medical oncologist to determine the best treatment regimen for patients diagnosed with these cancer types.
PD-L1 is a protein in your body that helps predict how well you might respond to immunotherapy. Your doctor will advise you whether you need this test before you can begin immunotherapy, or whether this test is not necessary for the cancer type you are treating.
If your doctor does send you for PD-L1 testing, here’s what will happen:¹
- A healthcare professional will take a tissue sample from your tumor. This is called a biopsy.
- The sample is sent to a pathologist who is trained in PD-L1 testing.
- After 7 to 10 days, the results are sent back to your doctor, who will call you in to discuss your results.
- Based on the level of PD-L1 found in your tumor, your doctor will discuss with you if he or she thinks immunotherapy looks like a good treatment option. This will help you in making an informed decision on which treatment option to take.
Medication administration
Immunotherapy is usually administered via intravenous (IV) infusion. A needle will be inserted into your vein so the medication can drip in.¹
The infusion process can last 30 minutes, depending on the type of cancer you are treating.1 For combination treatment of immunotherapy and chemotherapy, infusion can take up to 2 hours, depending on the medications.
After 2 to 4 weeks,1 you need to return to the hospital or clinic to receive another dose of the infusion. The total number of doses you need to receive – and, in effect, the number of weeks you need to return to receive a new infusion – depends on how the cancer responds to the treatment.¹,
There are some reasons why your doctor may stop treatment with immunotherapy:1
- Your tumor has stopped responding to the immunotherapy
- You are experiencing intolerable adverse effects
Common side effects
As with any medication, patients who receive immunotherapy may experience unintended effects.
The following adverse events have been observed in fewer than 10% but greater than 1% of people who receive immunotherapy alone:¹
- tiredness
- pain in the muscles, bones or joints, stomach area or other parts of the body
- decreased appetite
- itching
- diarrhea
- nausea
- rash
- fever
- cough
- shortness of breath
- constipation
Unlike cancer, none of these adverse events are deadly. They generally disappear the moment immunotherapy treatment is stopped.¹
Your doctor may prescribe immunotherapy despite the possibility of these adverse events because he/she has been trained to weigh the benefits against risks, and in his or her judgement, the benefit of immunotherapy may be greater than the risk of possible adverse events.
Please consult your medical oncologist for further guidance if you’re considering immunotherapy as treatment option.
Serious side effects
Some adverse events occur in fewer than 1% of patients who receive immunotherapy, and when they do occur, they can
- Lengthen the amount of time the patient needs to stay in the hospital
- Result in a significant disability that may not go away immediately even after immunotherapy treatment has stopped
- Cause – or pose a risk of – death¹
Your doctor should give you a list of symptoms that you should watch out for, but you should report all symptoms to your doctor immediately.
Your doctor is trained to recognize if a symptom can develop into a serious condition.
Some conditions that seem ordinary, such as constipation, dark urine, or weight loss or gain can signal a more serious condition such as organ problems when they occur in a patient receiving cancer treatment.
If your doctor finds that your symptoms may become more serious, your doctor may
- Give you additional medicines to control the symptoms
- Pause your immunotherapy treatment until the symptoms disappear
- Stop treatment with your current immunotherapy medication and transfer you to a different medication or mode of treatment
Other warnings
Immunotherapy in organ transplant recipients may result in organ rejection.¹
Some immunotherapy-related adverse events are not readily felt and can only be detected in a timely manner through laboratory tests. Make sure you do not miss your lab test appointments.
Animal studies have shown that immunotherapy medication may harm an unborn baby.¹ If you must take immunotherapy while pregnant, you must understand that this puts the baby at risk.
Patients are usually advised to ensure they do not get pregnant while taking immunotherapy and up to 4 months after receiving their last dose. Do not breastfeed while receiving immunotherapy and until 4 months after you have received your last dose.¹
Immunotherapy is a powerful weapon against cancer. It offers new hope to patients whose cancer was previously considered untreatable.
Immunotherapy cost in the Philippines warnings
To know about the cost of immunotherapy in the Philippines, consult your doctor or Find a Doctor.
As with everything, innovative treatments should be used with great understanding. Read the patient information or the prescribing information for the specific immunotherapy drug you are taking. Every piece of knowledge you gain improves your chances of beating your disease.
REFERENCES
- WebMD. Starting immunotherapy: what to expect. https://www.webmd.com/lung-cancer/lung-cancer-immunotherapy-what-to-expect#1. Accessed December 21, 2018.
- World Health Organization. Definitions. http://www.who.int/medicines/areas/quality_safety/safety_efficacy/trainingcourses/definitions.pdf. Accessed December 21, 2018