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38

NCCN Guidelines for Patients

®

:

Rectal Cancer, Version 1.2017

3

Overview of cancer treatments

Immunotherapy

PD-1 inhibitors are a type of medicine that stops the

action of PD-L1. They attach to PD-1 on T-cells. This

blocks PD-L1 on cancer cells from attaching.

See

Figure 15

. Thus, T-cells are able to attack cancer

cells.

There are two types of PD-1 inhibitors used for rectal

cancer. Their structures differ from each other. As a

result, each one attaches to PD-1 in a different way.

They are described next.

Nivolumab

Nivolumab is sold as Opdivo

®

. It is given by infusion

every two weeks. It takes about 60 minutes to

receive the full dose.

One common side effect of nivolumab is feeling tired.

Other common side effects are diarrhea, nausea,

constipation, and not feeling hungry. A rash may

appear on your skin or your skin may itch. You may

get a cough, have trouble breathing, or get an airway

infection. Muscle, bone, and joint pain and fever are

also common. Severe problems with your lungs, gut,

liver, kidney, skin, and hormones may occur.

Pembrolizumab

Pembrolizumab is sold as Keytruda

®

. Pembrolizumab

is given by infusion. It is given every three weeks. It

takes about 30 minutes to receive the full dose.

Side effects are much like those for nivolumab. You

may feel tired. You may also have problems with your

gut, skin, airways, and muscles. Severe problems

with your lungs, gut, liver, kidney, skin, and hormones

may occur.

Figure 15

Immunotherapy

Some rectal cancers consist of

cells that have PD-L1 on their

surface. PD-L1 attaches to PD-1

on T-cells. This stops T-cells

from attacking cancer cells. PD-1

inhibitors attach to PD-1 and block

PD-L1. As a result, T-cells are able

to attack cancer cells.

Copyright © 2017 National Comprehensive Cancer Network

®

(NCCN

®

).

www.nccn.org

T-cell

PD-L1

PD-1

nivolumab

pembrolizumab

cancer cell