Immunotherapy may utilize the body’s own immune system to fight the cancer, but that does not mean that it comes free of side-effects.
What are the side-effects and how serious can they be? These are all questions patients may have for doctors when beginning immunotherapy treatment for mesothelioma. Michelle Turner, NP (Johns Hopkins) and Jarushka Naidoo, MD (Johns Hopkins and Beaumont Hospital) converse about what patients can expect from immunotherapy treatments with. The conversation is moderated by Mary Hesdorffer, NP expert nurse practitioner and executive director of the Mesothelioma Applied Research Foundation Executive Director, about what patients can expect from immunotherapy treatments.
Introduction to immunotherapy
To explain immunotherapy (which was recently approved by the FDA as a first line treatment for mesothelioma), it’s important for doctors to communicate effectively to patients the differences between chemotherapy and immunotherapy. For one, chemotherapy suppresses the immune system to kill cancer cells, while immunotherapy uses the body’s own immune system to help recognize the tumor and kill it. Another difference between the two treatments is predictability. Chemotherapy is very predictable in how a patient will react to it because clinicians have decades of experience treating patients with it. Immune-related toxicities are different and distinct from chemotherapy.
Some side-effects of immunotherapy can include joint aches and pain, shortness of breath and colitis, pneumonitis, and myocarditis. The timing of those toxicities is unpredictable with immunotherapy, which can occur anywhere from the same day as treatment to many months and years after treatment has stopped. A variety of organ systems of the body can become inflamed as a reaction to the immunotherapy treatment. Immunosuppressive medicines can help treat the inflammation, while specific medicines are used to target inflammation of specific organs.
Does age matter?
The majority of data suggests older patients are just as likely to benefit from immunotherapy as younger ones. When it comes to side-effects, the rates are similar between older and younger patients as well.
During treatment
The duration of treatment will depend on what the individual treatment requires. Patient response can take as long as 9-12 weeks and there is a possibility of stability and growth while the immune system reacts to the tumor. A Johns Hopkins clinical trial is looking into certain markers in the blood to learn if we can predict which patients will respond to treatment. Having a better understanding of the patient population that benefits from immunotherapy would spare those who wouldn’t benefit of unnecessary toxicities.
Immunotherapy and side-effects
Certain toxicities are challenging for doctors to diagnose and manage. To expertly take care of a patient’s treatment and care, Dr. Naidoo, suggests working with a multi-disciplinary team including an organ specialist, gastroenterologist, neurologist, cardiologist, endocrinologist, pulmonologist, dermatologist and rheumatologist. Dr. Naidoo emphasized the importance of early recognition of adverse events.
“If doctors are aware that toxicities are happening, they can be treated and patient outcomes can be better,” she said.
Patients who are in the process of evaluating treatment options are encouraged to consult with the Mesothelioma Applied Research Foundation’s nurse practitioner by clicking here, to answer any questions and provide any additional information needed to help in the decision-making process.
Our sponsors
MesoTV is a program by the Mesothelioma Applied Research Foundation. This program is made possible by our generous sponsors: Maune Raichle Hartley French & Mudd, LLC (MRHFM); Belluck & Fox; Bristol Myers Squibb; Novocure; Merck; The Gori Law Firm; Early Lucarelli Sweeney & Meisenkothen.
