My oncologist has put me down for palliative treatment with Carboplatin and 5FU, but is reluctant to include Pembrolizumab (as recommended by NICE). I am being told that there are risky (and potentially permanent) side effects that can be caused by Pembrolizumab, whether you benefit from it or not.
The write up by NICE is much more positive, so I am asking around for any real world experiences with this immunotherapy drug please, whether lung or head and neck cancer based?
Thanks a lot for any answers, there must be a real depth of knowledge out there?
Hi,
Basically, you need to have a more in-depth conversation with your oncologist to understand your treatment options. NSCLC with a PDL-1 expression better than 50% responds well to Pembrolizumab, but not always and other lung cancers not so much. The side effects vary from one person to the next and can be mild indeed but, again, not always - it's a suck-it-and-see thing.
As ever, a little knowledge can be a dangerous thing so you'll need to do more reading - much will be heavy going. Kick off with user-friendly Lungevity:
www.lungevity.org/.../squamous-cell-lung-cancer then follow the links.
After that bear in mind that Pembrolizumab is not a one-fits-all treatment even for high PDL-1 expression: for primary squamous cell lung carcinoma it can actually make survival worse: pmc.ncbi.nlm.nih.gov/.../
Your oncologist should ideally welcome questions and have a good handle on what is best suited for you and your condition. If you cannot get a good explanation then you could invoke Martha's Rule to force a second opinion.
kind regards
Steve
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