The oncologist said “immunotherapy” and “targeted therapy” in the same sentence, and the family went home with two new words and no idea what they meant. These treatments have changed cancer care in the past decade. They are not right for everyone, and they can be expensive. This guide explains them simply — and shows where costs come from.
Immunotherapy and targeted therapy, simply
Immunotherapy helps your own immune system recognise and attack cancer. The most common drugs are “checkpoint inhibitors” — such as pembrolizumab or nivolumab — which release a brake that some cancers put on immune cells. They are now used for several cancers, including some lung, kidney, skin, head-and-neck and bladder cancers, depending on the tumour’s features.
Targeted therapy aims at a specific fault inside cancer cells — for example, an EGFR or ALK change in some lung cancers, or the HER2 protein in some breast and stomach cancers. Many are tablets; others, like trastuzumab, are infusions.
Both work only when the cancer has the right target. That is why testing comes first.
It helps to set expectations early. For some people, these drugs keep cancer under control for a long time; for others, they do not work, or side effects mean stopping. Doctors judge response with scans every few months. Immunotherapy can also act slowly — a scan can sometimes look worse before it looks better — so decisions are made by the specialist team, not on a single report. No honest doctor can promise a result, and neither can we.
Testing comes first
Before any of these drugs, your oncologist will want the tumour tested. Depending on the cancer, that may include PD-L1 levels, mismatch-repair or microsatellite status, and a gene panel (next-generation sequencing) to look for targetable mutations. Leading Indian cancer centres offer these tests, and results usually take one to three weeks.
- Keep the original biopsy tissue blocks and slides safe. They are needed for testing and for a second opinion.
- Bring scans on a disc in DICOM format, not just printed reports.
- Ask whether testing has already been done at home — repeating it wastes time and money.
Why a second opinion is worth it
Cancer treatment plans are complex: which drug, in which order, combined with chemotherapy, surgery or radiotherapy, or not at all. A second opinion from a multidisciplinary tumour board — where surgeons, medical and radiation oncologists, pathologists and radiologists review your case together — can confirm the plan, refine it, or occasionally change it.
The most valuable part of a second opinion is often the pathology review. A specialist pathologist re-examines your biopsy slides; sometimes the tumour type or its markers are reclassified, which can change which drugs are suitable. Ask whether your slides and blocks can be couriered for review before you fly.
You can often get one before you travel. Send your reports, scans and pathology, and a specialist reviews them on a call. A US$99 consultation includes two calls — a follow-up with the same oncologist or an opinion from a second one. We will never push you towards a treatment.
What drives the cost
| 2021 | 14.26 |
|---|---|
| 2025 | 15.7 |
ICMR National Cancer Registry Programme estimates, Rajya Sabha reply reported by ThePrint, 11 March 2026.
More patients means more demand — and India’s answer has been an unusually strong biosimilar industry. A biosimilar is a highly similar, approved version of a biologic medicine made after the original’s patent ends. Indian biosimilars of trastuzumab, bevacizumab and rituximab have been on the market for years, and companies are preparing pembrolizumab versions for when patents expire.
The main cost drivers are:
- The drug and brand: originator or biosimilar, where one exists.
- Dose: some drugs are dosed by body weight, others at a fixed dose.
- Number of cycles: many immunotherapies are given every three or six weeks for months.
- Combination: with or without chemotherapy.
- Day-care, scans and blood tests to monitor response and side effects.
Families sometimes ask whether a biosimilar is “second best”. Biosimilars are approved by regulators after studies showing they work the same way, with the same safety profile, as the original medicine. Your oncologist can tell you which brands they trust and use.
Ask for an itemised estimate per cycle and for the whole planned course. Buy cancer medicines only through the hospital pharmacy or an authorised distributor: WHO has warned about falsified versions of branded immunotherapy in circulation.
Planning treatment in India
- Remote review: reports, scans and pathology reviewed on a call.
- First visit (about 1–2 weeks): examination, any repeat tests, tumour board and the first cycle.
- Next steps: some patients stay for several cycles; others continue at home with a shared plan, returning for scans.
- Side effects: immunotherapy can inflame the skin, gut, lungs, liver or hormone glands. Carry a card naming your drug and the team’s contact details.
For longer treatments, our long-term care starts from US$1,299 a month per patient. Read our cancer care guide and second opinion guide, or send us your reports.
Independent research. Figures are quoted from the official and published sources listed below, as they stood when we checked them (October 2026). BookMedTrip is an independent facilitator and is not affiliated with any government body, hospital, charity or organisation named here, and receives no commission from them. If anything here is out of date or inaccurate, please write to care@bookmedtrip.com and we will correct it.
Вопросы
What is the difference between immunotherapy and targeted therapy?
Immunotherapy helps the immune system attack cancer; targeted therapy blocks a specific fault inside cancer cells. Both need the right tumour test results.
How much does immunotherapy cost in India?
It depends on the drug, dose and number of cycles. A single dose of branded pembrolizumab costs roughly ₹2–4 lakh in India; biosimilars, where available, cost less.
Can I get a second opinion on my cancer treatment from India?
Yes. Send your reports, scans and pathology; an oncologist reviews them on a call. A US$99 consultation includes two calls.
