Immunotherapies are drug treatments that aim to enhance your own body’s immune system so that it can recognise and destroy cancer cells more effectively.  By enhancing the immune system, it is very common for healthy parts of the body to be affected too.  There are now a number of immunotherapy drugs available that may be offered to you. They are given via an intravenous drip, usually in hospital.  Immunotherapies can be given as a single agent or as a combination of two of these drugs: Nivolumab and Ipilimumab.  All of these treatments have been assessed and have been approved for use in the UK.

Single Agents

Single agent refers to drugs that are administered to patients as individual treatments, as opposed to combinations of more than one drug.

NIVOLUMAB OR PEMBROLIZUMAB OR IPILIMUMAB

Your doctor will discuss with you the probabilities of treatments working and the potential side effects.

Risks and side effects

All cancer drug therapies are associated with some side effects that may impact on daily life to a lesser or greater extent.  As immunotherapy treatment affects the immune system, this may cause inflammation in different parts of the body which can cause serious side effects. They could happen during treatment, or some months after treatment has finished. In some people, these side effects could be life-long and can occasionally be life-threatening.  You may be affected by one or more side-effect.  Generally, many side effects can be dealt with if treated promptly.  Below includes some of the common side effects of these drugs:

COMBINATION THERAPY

Nivolumab and Ipilimumab

Combination therapies in this setting refer to the use of the two immunotherapy drugs Nivolumab and Ipilimumab given together. Both drugs are given intravenously every three weeks for four doses (provided there are no significant side-effects) followed by Nivolumab given on its own every 2 or 4 weeks for as long as the treatment is working or until any unacceptable side effects arise. However, if you are in remission after 2 years of treatment, you may be offered to discontinue your treatment.  In such cases, treatment may be restarted at a future time-point.

Your doctor will be able to discuss the pros and cons of combination therapy with you.

Side effects of Ipilimumab and Nivolumab

All cancer drug therapies are associated with some side effects that may impact on daily life to a lesser or greater extent.  As immunotherapy treatment affects the immune system, this may cause inflammation in different parts of the body which can cause serious side effects. They could happen during treatment, or some months after treatment has finished. In some people, these side effects could be life-long and can occasionally be life-threatening.  You may be affected by one or more side-effect. Generally, many side effects can be dealt with if treated promptly.

Whilst combination therapy is more effective than single agent immunotherapy, the risks of side effects are greater.  Below includes some of the common side effects of these drugs:

Bowel inflammation causing diarrhoea (contact your doctor or nurse straight away if you have any signs of diarrhoea or you open your bowels more often than usual), skin rashes, liver problems and effects on the hormone producing glands and nervous systems may be experienced. In addition, tiredness, cough, breathlessness, muscle pain, decreased appetite, feeling sick, weakness, fever, abdominal pain, chest pain, and joint pain may occur. More information on ipilimumab and nivolumab, including potential side effects, can be found here

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