Know About Immunotherapy
1) Are there any side-effects that I should know about ?
Unlike traditional chemotherapy which causes side effects like hair loss, nausea, vomiting, low blood counts, diarrhea etc, immunotherapy drugs have a different side effect profile.
Many patients do not have any side effects at all!
A few patients develop mild side effects like fatigue, skin rashes , thyroid hormonal fluctuations etc and these are easily managed.
However, in a small minority of patients (3-5%), the immune system becomes overly active and can attack the normal organs like the lungs, liver, intestine etc. In such a scenario, we temporarily hold the drug and give the patients steroid medications to suppress the immune system and prevent further damage.
2) How costly is Immunotherapy?
The most commonly used immunotherapy drugs currently in India, Nivolumab and Pembrolizumab, are very expensive. A single vial of pembrolizumab (Keytruda,100mg) costs approximately INR 1.97 Lakh. These medications have to be given intravenously every 3 weeks for a prolonged period to achieve their therapeutic benefits.
However, do not lose hope just yet. There are certain ways by which the financial toxicity of these medications can be reduced. One way is the use of ‘low-dose immunotherapy’, in which these drugs are used at much lower doses than the US FDA approved dosages. The rationale behind this is that there is some evidence from smaller studies that unlike traditional chemotherapy drugs, immunotherapy drugs are effective even when given at these low doses. This strategy will ensure that these potentially life-saving medicines reach out to as many cancer patients as possible. There are ongoing clinical trials in India that are testing low-dose immunotherapy in cancer patients.
3) Who should I take this treatment under ?
It is vital that treatments like chemotherapy and immunotherapy always be taken under the supervision and guidance of a trained medical oncologist only, who will explain the benefits, side effects and precautions in detail to the patient and their family members and will also be available round-the-clock in case any minor/major side effects emerge during treatment. This way, the patients can expect the best chances of getting cured and prolonging their life.
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