Immunotherapy for small intestine cancer

Immunotherapy (sometimes called biological therapy) helps to strengthen or restore the immune system's ability to fight cancer. This works to kill cancer cells and stop cancer cells from growing and spreading.

Some people with small intestine adenocarcinoma have immunotherapy. You may be offered immunotherapy if the cancer has spread to other parts of the body and doesn't respond to other treatments.

If you have immunotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

The type of immunotherapy drugs used for small intestine adenocarcinoma are called immune checkpoint inhibitors.

The immune system normally stops itself from attacking normal cells in the body by using specific proteins called checkpoints. Checkpoints slow down or stop an immune system response. Small intestine adenocarcinoma cells can sometimes use these checkpoints to hide and avoid being attacked by the immune system. Immune checkpoint inhibitors work by blocking the checkpoint proteins so immune system cells (called T cells) attack and kill the cancer cells.

Immune checkpoint inhibitors may be offered for small intestine adenocarcinoma if the tumour has certain genetic changes known as high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). These drugs will only be tried if the cancer has spread and doesn't respond to other treatments.

If small intestine adenocarcinoma has these features, the following immune checkpoint inhibitors may be used:

• pembrolizumab (Keytruda)
• nivolumab (Opdivo)
• dostarlimab (Jemperli)

These drugs are all given intravenously (through a needle in a vein).

Immunotherapy drugs for MSI-H or dMMR tumours may not be covered by all provincial or territorial drug plans. Your doctor or healthcare team will discuss access to these drugs with you and if you may benefit from this treatment.

Researchers are currently looking into using other immunotherapy drugs for small intestine adenocarcinoma.

Side effects of immunotherapy will depend mainly on the type of drug or drug combination, the dose, how it's given and your overall health. Tell your healthcare team if you have side effects that you think might be from immunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Common possible side effects of immunotherapy for small intestine cancer include:

• flu-like symptoms, such as fever and chills
• fatigue
• skin problems, including redness, rash, itching and dryness
• diarrhea
• nausea and vomiting

Immunotherapy drugs can have serious and potentially life-threatening side effects because they can make your immune system work against your organs. Talk to your healthcare team to learn more about the side effects of this treatment.

Find out more about immunotherapy. To make the decisions that are right for you, ask your healthcare team questions about immunotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.