How immunotherapy is given

Checkpoint inhibitors are usually prescribed by a medical oncologist or haematologist. They are given as a liquid through a drip inserted into a vein (intravenous infusion). Sometimes two or more drugs may be given together, such as two checkpoint inhibitors, or a checkpoint inhibitor with one or two chemotherapy drugs or a targeted therapy drug.

You will usually have immunotherapy as an outpatient, which means you visit the hospital or treatment centre for the infusion and then go home again. Checkpoint inhibitors are commonly given in repeating cycles, with rest periods of 2–6 weeks in between.

How often and how long you have the treatment depends on the type of cancer and how advanced it is; the type of checkpoint inhibitor; how the cancer responds to the treatment; and what side effects you experience. Many people stay on immunotherapy for up to two years.

Clinical trials are now testing if the treatment can be given for a shorter period of time once it has started working or whether ongoing treatment is needed.

Checkpoint inhibitors can take weeks or months to start working, depending on how your immune system and the cancer respond. Sometimes they keep working long after treatment stops, but this varies from person to person.

Most cancers have treatment protocols that set out which drugs to have, how much and how often. You can find information about protocols for checkpoint inhibitors and other cancer drugs at eviQ Cancer Treatments Online.

Your specialist may need to tailor the protocols to your individual situation. Like many other cancer treatments, immunotherapy drugs are often not safe to use if you are pregnant or breastfeeding. Ask your doctor for advice about contraception. If you become pregnant, let your medical team know immediately.

What if I have an autoimmune disease? – It is important to tell your cancer specialist if you have an autoimmune disease such as rheumatoid arthritis, lupus, ulcerative colitis and Crohn’s disease. You may still be able to have immunotherapy, but there will be extra issues to consider.

Autoimmune diseases make the body’s immune system overactive so it attacks normal cells, causing redness, swelling and pain (inflammation). The extra immune system activity caused by immunotherapy can make these symptoms worse.

What if I’ve had an organ transplant? – If you have had an organ transplant, you will probably be taking medicines that suppress the immune system and stop your body from rejecting the new organ. Talk to your specialists, as they will need to carefully balance these medicines with the extra immune system activity caused by immunotherapy.

Let your treatment team know about any over-the-counter medicines, vitamins, supplements or herbal therapies you are thinking about using. Some may affect how the immunotherapy works or make side effects worse.