Immunotherapy for Nasal Cavity and Paranasal Sinus Cancers

Immunotherapy is a type of cancer treatment that helps the immune system find and attack cancer cells. It can sometimes help treat nasal cavity and paranasal sinus cancers.

Immune checkpoint inhibitors

Just as it’s important that immune cells get activated to fight infections, it’s also important that they turn off when they are no longer needed. Checkpoint proteins on immune cells act as brakes to slow down immune attacks.

Cancer cells sometimes use these checkpoints to keep from being attacked by the immune system.

Drugs that target these checkpoint proteins, called checkpoint inhibitors, can help restore the immune response against the cancer cells.

PD-1 inhibitors

Pembrolizumab (Keytruda and Keytruda Qlex) and nivolumab (Opdivo and Opdivo Qvantig) are drugs that target PD-1, a protein on immune system cells called T cells. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

These drugs can be used in people with squamous cell cancers of the nasal cavity or paranasal sinuses in different situations.

Pembrolizumab can be used in different scenarios:

• For cancers that are locally advanced (have spread nearby but not yet to distant parts of the body), resectable (able to be removed with surgery), and have the PD-L1 protein. Pembrolizumab can be given before surgery and then continued after surgery, along with radiation therapy and possibly chemotherapy.
• For cancers that have returned after treatment and can’t be treated with surgery or that have spread to other parts of the body, either alone (if the cancer cells have the PD-L1 protein) or with chemotherapy.
• By itself for cancers that have returned after treatment or that have spread to other parts of the body, if chemotherapy stops working.

Nivolumab can be used for cancers that have returned after treatment or that have spread to other parts of the body if chemotherapy stops working.

These drugs are given either as an IV infusion or as an injection under the skin, typically every 2 to 6 weeks.

Possible side effects of checkpoint inhibitors

It’s very important to report any new side effects during or after treatment with any of these drugs to your health care team right away. If serious side effects do occur, you  might need to stop treatment and take medicines to suppress your immune system.

Side effects of these drugs tend to be mild and can include:

• Fatigue
• Cough
• Nausea
• Itching
• Skin rash
• Loss of appetite
• Diarrhea
• Joint pain

Rare but serious side effects

Infusion reactions: Some people might have an infusion reaction while getting these drugs. This is like an allergic reaction and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It’s important to tell your doctor or nurse right away if you have any of these symptoms while getting one of these drugs.

Autoimmune reactions: These drugs work by removing one of the safeguards from the body’s immune system. Sometimes the immune system then starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.