The challenges of immunotherapy
You may have several questions and concerns about having immunotherapy. There have been media reports of how immunotherapy is a “miracle drug” and how it can cure cancer. This means that people’s expectations can be very high when starting treatment, or they may be confused and upset if they aren’t offered immunotherapy as part of their treatment.
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The most challenging issue is that checkpoint immunotherapy doesn’t work for everyone. If you are thinking about trying immunotherapy, ask your cancer specialist how likely you are to respond to the treatment and what other treatments are available. To make immunotherapy available to more people in the future, researchers are trying to understand why some people respond better than others.
|If immunotherapy doesn’t work or stops working, ask your cancer specialist about your other treatment options. You may be able to try another type of immunotherapy drug or join a clinical trial.|
Like most other cancer treatments, checkpoint immunotherapy usually takes a while to work, so you and your family may experience anxiety waiting to see whether you’ll respond to the treatment. If it does work, you may worry about how long immunotherapy will control the cancer or whether the cancer will come back.
These uncertainties can make it challenging to make plans about work, relationships and travel. Many people find comfort in everyday activities; others focus on doing things they’ve always wanted to do. Let your cancer nurse or specialist know how you’re feeling. They may recommend seeing a psychologist to help you work through your thoughts.
See Emotions and cancer for more information on coping with uncertainty.
The cost of checkpoint immunotherapy drugs is high (often several thousand dollars per dose).
As at June 2019, the Australian Government covers most of this cost for some types of advanced cancer through the Pharmaceutical Benefits Scheme (PBS). Reimbursement for some other types of cancer may be added in the future. Your specialist can give you the latest information.
Advanced cancer type
Checkpoint inhibitors available on the PBS
|melanoma||pembrolizumab (brand name Keytruda), nivolumab (Opdivo), ipilimumab (Yervoy)|
|lung cancer||pembrolizumab, nivolumab, atezolizumab (Tecentriq)|
|kidney cancer||nivolumab, ipilimumab|
|head and neck cancer||nivolumab|
|Merkel cell carcinoma||avelumab (Bavencio)|
You may be able to access checkpoint immunotherapy through clinical trials or, sometimes, through a compassionate access program or cost-share program offered by the pharmaceutical company.
Some people choose to make significant financial decisions to cover the costs of immunotherapy for cancers that are not on the PBS. Before deciding to pay for these drugs, it is important to fully understand the financial costs, as well as the possible risks and benefits for your type of cancer. Take the time to discuss these questions with your cancer specialist and your family.
A/Prof Brett Hughes, Senior Staff Specialist, Medical Oncology, Royal Brisbane and Women’s Hospital and The Prince Charles Hospital, and Associate Professor, The University of Queensland, QLD; Dawn Bedwell, 13 11 20 Consultant, Cancer Council Queensland, QLD; Tamara Dawson, Consumer; A/Prof Craig Gedye, Senior Staff Specialist, Medical Oncology, Calvary Mater Newcastle, and Conjoint Associate Professor, School of Medicine and Public Health, University of Newcastle, NSW; A/Prof Alexander Menzies, Medical Oncologist, Associate Professor of Melanoma Medical Oncology, and Faculty Member, Melanoma Institute Australia, The University of Sydney, Royal North Shore Hospital and Mater Hospital, NSW; Dr Donna Milne, Nurse Consultant Melanoma and Skin Service, Peter MacCallum Cancer Centre, VIC; Dr Geoffrey Peters, Staff Specialist, Medical Oncology, Canberra Hospital and Health Services, and Clinical Lecturer, Australian National University, ACT.
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