Patient Introduction

Hello, my name is Alice, and I’m 63 years old. I was diagnosed with metastatic non-small cell lung cancer a few weeks ago. I smoked at least 1-2 packs a day for about 30 years but quit 10 years ago when my sister, who also smoked, was diagnosed with COPD. I quit cold turkey, because I was scared I would need to carry around oxygen if I ended up with COPD too. My doctor told me that surgery wasn’t an option for me but recommended chemotherapy plus another medicine. I have heard that you lose your hair and appetite and throw up a lot with chemotherapy. But my hairdresser told me about her family member who is also getting treatment for lung cancer with other medications that aren’t chemo. My right side is also bothering me; I have pain when I sleep on that side. I think it might be related. I’m hoping to get other opinions on the best therapy for me.

Question #1

How are you feeling now Alice? Any symptoms? For example, pain, coughing, or weight loss?

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Question #2

Let’s talk about your overall health a little bit, Alice. Do you have any other health conditions? Has anyone ever told you that you have an autoimmune disorder?

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Question #3

You have a type of non-small cell lung cancer called squamous cell carcinoma. Biomarker testing was ordered to help us choose the best cancer treatment for you. Did anyone discuss those results with you?

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Question #4

PD-L1 is a “stop signal” that tumors use to hide from your immune system. Immunotherapy helps your body’s immune system recognize and attack cancer. Your tumor has a low level of PD-L1. Was immunotherapy discussed with you?

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Question #5

Alice, please talk to me a little more about the side effects that you are most concerned about.

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Question #6

We have very good medicines to help with nausea and vomiting. Almost everyone loses their hair with this chemotherapy regimen, however. The other drug is called immunotherapy—usually pembrolizumab or cemiplimab. Have you heard anything about it?

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Question #7

Most people don’t have too many side effects with immunotherapy. But, they can happen. What side effects do you know about?

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Question #8

Immunotherapy can confuse the immune system, which leads to it attack normal cells, causing rash or diarrhea or other issues. However, the side effects usually are quite manageable. Many patients can keep working. What do you do for work?

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Question #9

The low PD-L1 biomarker means that you are eligible for immunotherapy, but it works better when used in combination with 2 types of chemotherapy, carboplatin and paclitaxel.

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Question #10

It is called paclitaxel. The brand name is Taxol. The most common side effects with Taxol are nausea, vomiting, diarrhea, fatigue, hair loss. But, I mentioned, we have good medicines for the nausea and vomiting now.

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Question #11

You get carboplatin and paclitaxel every 3 weeks for about 4 times, so about 3 months total. Then you continue taking the immunotherapy for up to 2 years. Many patients stay on it the full 2 years.

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This activity is provided by Med Learning Group.
This activity is supported by an independent educational grant from Regeneron Pharmaceuticals, Inc.

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