How effective is immunotherapy for non-small cell lung cancer?

Unlike chemotherapy, immunotherapy is designed to help the immune system recognise cancer cells. It may be offered alone, alongside chemotherapy, or after other treatment, depending on whether the cancer is localised, locally advanced or has spread. Some tumours have features that make an immune response more likely, such as higher PD-L1 expression or particular molecular findings. A scan may show shrinkage, stable disease or growth, and symptoms do not always change at the same pace as scan results.

The response can take time to become clear. Benefits may continue while treatment is working, but cancer can also stop responding. Side effects can affect organs such as the lungs, bowel, liver, thyroid or skin, so treatment decisions balance possible benefit with safety.

Your oncology team will review the biopsy report, stage, PD-L1 result, molecular testing, previous treatments and your general health. Ask which immunotherapy medicine is being considered, whether it is combined with another treatment, and how scans will be used to judge response. Keep a record of new cough, breathlessness, diarrhoea, rash, fever or unusual tiredness. Do not stop treatment or start supplements without discussing them with the team.

Contact your cancer team promptly for new or worsening breathlessness, chest pain, persistent cough, severe diarrhoea, yellowing of the eyes, marked weakness, confusion, a widespread rash or fever. These symptoms can have several causes, but immune-related inflammation needs early assessment. Seek emergency help for severe breathing difficulty, fainting or sudden confusion.

Which tumour test results affect the choice of immunotherapy? What is the aim of treatment in my stage of disease? When will scans and blood tests be reviewed? Which symptoms should make me call the oncology team the same day?