New Injectable Immunotherapy for Lung Cancer Launched in India: Easier Alternative to Chemotherapy Offers Fresh Hope to Patients
A man around sixty years old, Raghav Kulshreshtra (name changed), a long-time smoker, arrived at the cancer department of Medanta in December after being diagnosed with advanced-stage lung cancer.
By the time doctors examined him, the disease had already spread to his brain, liver and bones.
Although he had begun radiation treatment to slow the growth of the tumours, he was deeply anxious about undergoing chemotherapy because of its well-known side effects.
To avoid that route, his doctors recommended immunotherapy, which is now available as a simpler injectable.
According to Dr Sajjan Rajpurohit, head of medical oncology at the hospital, the patient had become fearful after hearing difficult experiences from other chemotherapy patients.
Medical tests later showed that Jai Singh’s PD-L1 expression level was extremely high at 75 per cent.
Doctors explained that this protein acts like a protective shield used by cancer cells to escape detection by the body’s immune system.
Since a large percentage of his tumour cells carried this marker, he became an ideal candidate for immunotherapy.
Instead of the conventional intravenous infusion, doctors advised him to take the newly introduced under-the-skin injectable version of atezolizumab.
Global pharmaceutical company Roche has recently introduced the subcutaneous version of its cancer immunotherapy medicine atezolizumab in India under the brand name Tecentriq.
Dr Rajpurohit said the injectable format has made treatment significantly more convenient because patients no longer need to spend long hours in hospitals for infusions.
He added that the injection also appears to cause fewer infusion-related complications, improving treatment adherence among patients.
Who Can Receive This Immunotherapy Injection?
The therapy is designed mainly for patients suffering from non-small cell lung cancer, the most common form of lung cancer diagnosed in India.
Every year, the country records more than 81,000 cases of lung cancer, and a majority fall into this category.
However, the treatment is suitable only for a selected group of patients. Since the medicine specifically targets PD-L1 proteins present on cancer cells, only individuals with high PD-L1 expression are considered eligible.
Doctors estimate that nearly 50 per cent of non-small cell lung cancer patients may qualify for this form of treatment.
How Does the Treatment Benefit Cancer Patients?
Medical experts say both the intravenous and injectable versions of atezolizumab have demonstrated encouraging results in improving survival rates among lung cancer patients.
Studies show that the drug not only extends overall survival but also delays the progression of the disease while lowering the chances of death.
One major advantage of the newly launched subcutaneous version is the speed and simplicity of administration.
Unlike traditional IV therapy, which may take considerable time, the injectable dose can be given in the thigh within just seven minutes by trained nursing staff in outpatient departments.
Doctors believe this method also reduces the burden on hospitals. In the same amount of time it takes to administer intravenous therapy to one patient, nearly five patients can receive the injectable version.
International studies cited by the company further revealed that four out of five patients preferred the injection over IV treatment because of its convenience and shorter hospital visits.
Despite the medical advantages, the treatment remains financially challenging for many families. Each dose costs around Rs 3.7 lakh, and most patients typically require approximately six doses during the treatment cycle.
To make the therapy more affordable, Roche has introduced a patient-support initiative called Blue Tree, aimed at reducing costs and improving access for eligible patients.
The medicine has also been included under the Central Government Health Scheme.
Dr Rajpurohit explained that the injectable form requires a higher biologically equivalent dosage — 1,800 mg compared to 1,200 mg for the intravenous option — resulting in an additional cost difference of around Rs 25,000 to Rs 30,000.
However, he noted that patients save significantly on hospital admission charges, infusion expenses and extended hospital stays, making the total treatment expenditure nearly comparable.
How Does Atezolizumab Work Against Cancer?
Atezolizumab helps the body’s immune system recognise and fight cancer cells more effectively. Under normal conditions, immune cells known as T-cells constantly scan the body and destroy harmful or abnormal cells.
However, many cancer cells avoid destruction by producing a protein called PD-L1 on their surface.
This protein interacts with receptors on T-cells and sends a misleading signal that effectively tells the immune system to stand down.
As a result, cancer cells continue multiplying without resistance from the body’s natural defence system.
Atezolizumab blocks this deceptive communication by attaching itself to the PD-L1 protein and preventing it from switching off the immune response.
Once that protective barrier is removed, T-cells regain their ability to identify cancer cells as dangerous. The immune system then becomes active again and begins attacking and destroying the tumour cells.
