Coming to the end of my 2 year immunotherapy treatment for stage 4 lung cancer. What would be my next best medical option to improve survival? I know we are all different but any pointers would be much appreciated. Love health and strength to all.
You will, of course, need to discuss your options with your doctor(s).
As far as I know, those options (in no particular order) are:
a) Continue with pembrolizumab, paying for it privately. That costs approx £7k a dose, with no specified end date. (Not realistic for most, only included here for completeness.) Otherwise, wait and see what happens with your tumours: b) There's a good chance that they will remain stable (I've already posted on long-term outcomes after this treatment stops if you search my previous posts) with survival improving with how suitable you tested for immunotherapy. Long term (>=5years) survival rates are only just starting to get published, but so far they're looking good. Here's another paper in the subject: Google for "annals of oncology" pembrolizumab outcomes to get "Outcomes to first-line pembrolizumab in patients with non-small-cell lung cancer and very high PD-L1 expression". c) If the cancer resists immunotherapy and starts to come back (you should expect to get regular scans ongoing) what's left should be small enough to be suitable for radiotherapy and/or chemotherapy. d) Your consultant might argue your case with the NHS for resumption of immunotherapy if that has been shown to be successful for you. Whether that would be accepted by NHS might not be guaranteed though.
I'm in the same boat as you, but so far my health insurance is still paying out...
You will, of course, need to discuss your options with your doctor(s).
As far as I know, those options (in no particular order) are:
a) Continue with pembrolizumab, paying for it privately. That costs approx £7k a dose, with no specified end date. (Not realistic for most, only included here for completeness.) Otherwise, wait and see what happens with your tumours: b) There's a good chance that they will remain stable (I've already posted on long-term outcomes after this treatment stops if you search my previous posts) with survival improving with how suitable you tested for immunotherapy. Long term (>=5years) survival rates are only just starting to get published, but so far they're looking good. Here's another paper in the subject: Google for "annals of oncology" pembrolizumab outcomes to get "Outcomes to first-line pembrolizumab in patients with non-small-cell lung cancer and very high PD-L1 expression". c) If the cancer resists immunotherapy and starts to come back (you should expect to get regular scans ongoing) what's left should be small enough to be suitable for radiotherapy and/or chemotherapy. d) Your consultant might argue your case with the NHS for resumption of immunotherapy if that has been shown to be successful for you. Whether that would be accepted by NHS might not be guaranteed though.
I'm in the same boat as you, but so far my health insurance is still paying out...
