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Immunotherapy is the use of medicines to help a person’s own immune system recognize and destroy cancer cells. These drugs have side effects different from those of chemotherapy.

Immunotherapy is used to treat some types of uterine sarcoma.

Immune checkpoint inhibitors for uterine sarcoma

Just as it’s important that immune cells get activated to fight infections and cancer, 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 immune checkpoint inhibitors, can help restore the immune response against the cancer cells.

PD-1 inhibitors

PD-1 is a checkpoint protein on immune cells called T cells.

Pembrolizumab (Keytruda), a drug that targets PD-1, might be an option to treat some advanced uterine sarcomas with a high tumor mutational burden (TMB-H). By blocking PD-1, this drug boosts the immune response against cancer cells. This can often shrink tumors or slow their growth.

This drug is given into a vein (IV) as an infusion and is typically given every 3 or 6 weeks.

Nivolumab (Opdivo, Opdivo Qvantig), another PD-1 inhibitor, has also been used in combination with ipilimumab, another type of immune checkpoint inhibitor, to treat uterine sarcoma with TMB-H.

CTLA-4 inhibitors

CTLA-4 is another checkpoint protein on some T cells. Ipilimumab is a CTLA-4 inhibitor that might be used in combination with nivolumab for TMB-H uterine sarcoma.

Possible side effects of immune checkpoint inhibitors

Side effects of these drugs can include fatigue, cough, skin rash, poor appetite, constipation, diarrhea, and joint pain.

Other, more serious side effects occur less often.

Infusion reactions: Infusion reactions are like allergic reactions 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 these drugs.

Autoimmune reactions: These drugs can also cause immune cells to attack normal healthy cells throughout your body, leading to problems with your lungs, gut, hormone-making glands like the thyroid, kidneys, or other organs.

It’s very important to report any new side effects to your healthcare team quickly. If serious side effects do occur, treatment might need to be stopped, and you might need other treatment to stop these side effects.

To learn more about the side effects of immune checkpoint inhibitors, see Immune Checkpoint Inhibitors and Their Side Effects.