Once upon a time, the stage 4 level of lung cancer was very infamous because it was impossible to treat, and the patient eventually died due to this. But as of 2025, the biggest question is whether immunotherapy can really cure stage 4 lung cancer? In this article, we will look at how immunotherapy has evolved over the years. Can immunotherapy really save the life of a person suffering from lung cancer and looking for lung cancer treatment, especially at the last stage? Stage 4 lung cancer is known as metastatic. In simple words, stage 4 cancer means that cancer cells have reached and started affecting the nearby organs too.
What is Stage 4 Lung Cancer and Immunotherapy?
As we discussed earlier about stage 4 lung cancer, let’s discuss it again in brief. Also known as metastatic, when cancer cells start multiplying at a rapid rate and spread to other organs, from the lungs. Eventually, once started in the lungs, it damages the other parts too. If you can’t get treated immediately, it’s almost impossible to survive. If we talk about the stage 4 lung cancer treatment options, there used to be very limited treatment available at this stage before 2015.
Immunotherapy for non-small cell lung cancer, especially for stage 4, was introduced and approved in 2015. Immunotherapy immunises the body, or you can say it regains the ability of the immune system to fight cancer cells. In between, Immunotherapy vs chemotherapy for lung cancer, which is best? The answer depends on the condition for cancer for each specific patient. Chemotherapy treatment directly attacks the cancerous cells, unlike immunotherapy, which works organically, even for the whole body.
The Science Behind Immune Checkpoint Inhibitors
Using this is the most successful way of immunotherapy to treat stage 4 lung cancer. The medications used in this treatment target the specific protein in which cancer cells hide from the immune system. Destroying that protein eventually ends the cancer cell behind it. Some drugs and medications are listed below for reference:
PD-1/PD-L1 Pathway Inhibitors
- Atezolizumab (Tecentriq)
- Nivolumab (Opdivo)
- Cemiplimab (Libtayo)
- Pembrolizumab (Keytruda)
- Durvalumab (Imfinzi)
CTLA-4 Inhibitors
- Ipilimumab (Yervoy)
These checkpoint inhibitors detect and eliminate the malicious cells by improving the ability of the immune system immediately. It acts by blocking the communication between cancer cells and proteins that it hides from the immune system. It lowers the spread of cancer effectively.
Real-World Evidence of Immunotherapy Success
Comprehensive studies and deep researches shows that Immunotherapy has an important impact on the survival rates for patients with stage 4 lung cancer. Before immunotherapy, there was very less of life expectancy without treatment for stage 4 lung cancer. After introducing immunotherapy for stage 4, the research shows the database for one year, which significantly shows the high success rate of immunotherapy and the decline in the rate of deceased.
Database from the ream in the US shows some remarkable research outcomes:
- Survival rate is increased from 3 to 4 months to 15 to 20 months after having this combination of immunotherapy with other treatments.
- Some patients got completely cured from cancer, even from stage 4, which used to be almost impossible till 2015.
- Immunotherapy for patients with non-small cell lung cancer (NSCLC) at stage 4 has increased the survival rate by around 5 years.
Breakthrough Cases: When Immunotherapy Achieves Near-Cure Status
It is very confusing to use the word “cure” for stage 4 cancer, because it’s almost impossible to date. Immunotherapy is introduced to extend the survival a little more by improving the immune system. But there are a few documented cases that startled the world and the medical industry. One of the cases for non-small cell stage 4 cancer, where a patient suffering from the last stage of brain cancer with brain metastases is almost cured. The patient achieved a cure of the whole cerebral, pulmonary, and hepatic response, also sustained for the next 69 months, which is almost 6 years.
Cases and outcomes like this give a new hope to medical industries and cancer research teams to achieve the treatment that completely cures the cancer, even for those living in the last stages. Similarly, a case of a Navy veteran is also famous, as he recovered from last-stage cancer and back to regular activities with the help of regular treatments and immunotherapy, and their extreme side effects.
Combination Therapies: The Future of Lung Cancer Treatment
Immunotherapy is a good option, but outcomes have shown that the best results are often achieved by using a combination of treatments
- Targeted Therapy Plus Immunotherapy: Combining both of these is for only specific patients, especially those with specific genetic mutations.
- Immuno-Chemotherapy Combinations: Combining modern immunotherapy with traditional chemotherapy has shown some fantastic results. Studies show that the combination has increased the survival months to 15 from 12 months that chemotherapy used to provide alone.
- Adjuvant and Neoadjuvant Immunotherapy: Use of immunotherapy before and even after the surgery shows positive results for the immune system’s ability. It is beneficial for late-stage disease as well as helpful in earlier-stage diseases.
Next-Generation Immunotherapies in 2025
Immunotherapies are evolving day by day as researchers are doing their best to achieve the ultimate. There are some approaches listed below to achieve the best outcome out of it:
- Vaccines for Cancer: Combining the checkpoint inhibitors, some personalised vaccines according to patients offer hope for eliminating lung cancer.
- Bispecific Antibodies: Treatments that target both VEGF pathways and PD-1 altogether show the efficacy of the next generation of immunotherapy.
- Tumor-Infiltrating Lymphocyte Therapy: extraction of immune cells from the patient’s body, and modification of cells is done with the infusion to strengthen the immune system.
- CAR-T Cell Therapy: Earlier, it was used only in blood cancer cases, but later, CAR-T cell therapy evolved and achieved new heights. Solid tumours are also cured by this now, with positive outcomes.
Patient Selection and Biomarkers
A biomarker test is performed to determine the immunotherapy or the combinations that would be best for that specific patient. Some are listed below:
- Micro-satellite Instability: This high tumor reacts amazingly well with checkpoint inhibitors, although it is rare in lung cancer.
- Tumor Mutational Burden: Increased tumour mutational burden combines with better immunotherapy responses for several subtypes of lung cancer.
- Expression of PD-L1: Patients with PD-L1 expression show better results and outcomes compared with pembrolizumab mono-therapy.
Managing Expectations: The Reality of “Cure”
No doubt, immunotherapy has advanced and evolved too much, but still, the medical world uses the term “cure” for stage 4 lung cancer carefully. Not just curing, but they are also focused on many different aspects.
- Quality of Life: Increase the quality of life even after having treatments, and after treatments
- Progression-Free Survival: Extension of life, eliminating the growth of cancerous cells.
- Disease Control: Achieving stable disease or tumor shrinkage
- Survival Rate: Significantly increases the life expectancy
Some patients are cured from cancer, but what about the long-term side effects due to medications and treatment involved earlier? It significantly affects the quality of life.
Side Effects and Quality of Life Considerations
Immunotherapy has some less critical side effects compared with the side effects of chemotherapy. Some side effects of immunotherapy are listed below, and proper consideration for it.
- Allergies and reactions to the skin
- Inflammation in the lungs, pneumonitis. It is a non-infectious irritation, unlike pneumonia
- Autoimmune disorders or toxins in the body can cause inflammation in the liver, hepatitis.
- Colitis, an inflammation in the intestines, may result in bloody stools, diarrhea, or fever.
- Hormonal imbalance or endocrine disorders
Although these side effects are risky and serious, all of them can be managed by some proper interventions and timely monitoring.
The Economic Impact and Accessibility
Sessions of Immunotherapy are still not widely accessible or available at all places. And due to low availability, the cost is on the higher side. It is mostly available in metro cities and in developing or developed countries only. Some best countries for cancer treatment provide high results in immunotherapy. Medical tourism for cancer treatment is still suffering from the gap in the availability of immunotherapy. Sessions for giving immunotherapy require a high training and specialisation. This results in the increasing cost of providing it by healthcare providers.
Conclusion
The question “Can Immunotherapy Cure Stage 4 Lung Cancer?” doesn’t have a proper answer of yes or no. But still, we have seen the outcomes that immunotherapy is creating a very big impact in stage 4 conditions of lung cancer. And in some remarkable cases, we have also seen that the few combinations with immunotherapy have eliminated the cancer cells from the patients at stage 4.
It shows that if our medical researchers keep doing their best, the day is not far away when we will achieve a proper cure for cancer. The world is growing too fast, as well as the medical industry. But as of now, we can only rely on combinations of immunotherapy with other treatments for the best outcomes and to extend the survival periods. The revolution in lung cancer treatment continues.