Medical oncology · London
Immunotherapy infusion clinic private in London.
Outpatient checkpoint inhibitor therapy in a dedicated infusion suite, biomarker-selected and MDT-led, with 24/7 acute oncology cover for immune-related toxicity - across melanoma, lung, kidney, bladder and head and neck cancers.
Why patients choose us
- 01
A named oncologist, in a dedicated infusion unit
Not a general chemo chair. A consultant medical oncologist with a high checkpoint-inhibitor volume, in a unit set up for immune-related toxicity monitoring.
- 02
Biomarker-led selection, not a default protocol
PD-L1 CPS/TPS, MSI/dMMR, TMB and, where relevant, HER2 are checked before the first cycle so the right drug goes to the right tumour.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private immunotherapy costs in London.
Indicative per-cycle drug ranges across our partner units, before infusion suite fees and consultant charges. Full-course cost depends on drug, weight-based dosing and duration.
In short
A pembrolizumab or nivolumab cycle in our network: £3,500-£5,200, home the same day. Full course £45,000-£220,000.
| Drug | Indicative range | Infusion time | Schedule |
|---|---|---|---|
| Pembrolizumab (Keytruda) per cycle | £3,800-£5,200 | 30 min IV | Every 3 or 6 weeks |
| Nivolumab (Opdivo) per cycle | £3,500-£4,800 | 30 min IV | Every 2 or 4 weeks |
| Atezolizumab (Tecentriq) per cycle | £3,600-£5,000 | 30-60 min IV | Every 3 or 4 weeks |
| Durvalumab (Imfinzi) per cycle | £3,400-£4,700 | 60 min IV | Every 2 or 4 weeks |
| Ipilimumab-based combination per cycle | £8,500-£14,000 | 90 min IV | Every 3 weeks x 4 |
| Full course, 12 to 24 months (drug-dependent) | £45,000-£220,000 | Course | To progression |
Ipilimumab-nivolumab induction followed by nivolumab maintenance to 24 months typically totals £90,000-£180,000. Pembrolizumab monotherapy for two years is around £70,000-£110,000. We come back with a firm quote and confirm insurer cover within one working day.
What it is
Releasing the brakes on your own T cells.
Checkpoint inhibitors are monoclonal antibodies that block the switches tumours use to hide from the immune system - so your T cells can recognise and attack cancer cells directly.
-
Anti-PD-1 and anti-PD-L1
Antibodies against PD-1 (on T cells) or PD-L1 (on tumour cells) break the interaction that switches T cells off in the tumour microenvironment.
-
Anti-CTLA-4 and anti-LAG-3
CTLA-4 blockade broadens the T-cell response in lymph nodes. LAG-3 blockade releases an additional exhaustion checkpoint, most often combined with anti-PD-1.
-
Now standard-of-care across many cancers
From advanced melanoma in 2011 to tissue-agnostic MSI-H approvals today, checkpoint inhibitors are established practice across more than 20 licensed indications.
Cycle timing
From referral to response scan - what happens, in order.
Most infusions run 30 to 60 minutes every 2 to 4 weeks. Full courses run 12 to 24 months or until progression or unmanageable toxicity.
Phase 1 · Before your first cycle
Workup and MDT sign-off
Phase 2 · On the day
Two to four hours in the suite
Phase 3 · After
Cycle bloods and restaging
- 01
Before
You send us the histology and staging
A short, confidential form. Diagnosis, stage, prior lines of treatment, and any recent molecular profiling or PD-L1 status.
- 02
Before
MDT-level review and drug shortlist
Within one working day: which checkpoint inhibitor fits, whether a combination is indicated, and indicative cost per cycle and per full course.
- 03
Before
Baseline workup and consent
Baseline TFTs, cortisol, LFTs, renal function, glucose, CT staging and, where needed, echo. Written consent covering immune-related adverse events.
- 04
On the day
Arrival at the infusion suite
Pre-infusion bloods, obs and a review by the oncology team. Cannulation and premedication only if clinically indicated (rarely for anti-PD-1 monotherapy).
- 05
On the day
The infusion itself
30 to 60 minutes intravenously for most anti-PD-1 or anti-PD-L1 agents. Longer for the first ipilimumab-containing cycle. Observation for 30 minutes post-infusion.
- 06
On the day
Home the same day
Written irAE red-flag advice, a 24/7 acute oncology hotline number, and a symptom diary. Total time in the unit is usually two to four hours.
- 07
After
Cycle bloods and imaging response
Pre-cycle bloods every 2 to 4 weeks. Restaging CT at 9 to 12 weeks, then every 12 weeks. Course continues for 12 to 24 months or until progression or unmanageable toxicity.
Typical infusion: 30-60 min IV. Cycle interval: every 2-4 weeks. Total course: 12-24 months.
Drugs licensed
The checkpoint inhibitors we use, and how they differ.
Nine agents across four checkpoint families - each with its own licensed indications, dosing schedule and toxicity profile.
-
Pembrolizumab (Keytruda) - anti-PD-1
The most widely licensed checkpoint inhibitor, used across melanoma, NSCLC, HNSCC, urothelial, MSI-H tumour-agnostic, cervical, endometrial and more.
-
Nivolumab (Opdivo) - anti-PD-1
Melanoma (mono and with ipilimumab), NSCLC, RCC, urothelial, HNSCC, HCC, gastric and oesophageal cancers, and adjuvant use after resection.
-
Atezolizumab (Tecentriq) - anti-PD-L1
NSCLC (with chemotherapy), TNBC (PD-L1+ with nab-paclitaxel), urothelial, HCC (with bevacizumab) and small-cell lung cancer.
-
Durvalumab (Imfinzi) - anti-PD-L1
Stage III NSCLC consolidation after chemoradiotherapy (PACIFIC), extensive-stage SCLC, biliary tract cancer and HCC combinations.
-
Ipilimumab (Yervoy) - anti-CTLA-4
Almost always used in combination with an anti-PD-1 (nivolumab or pembrolizumab). Higher response rates, meaningfully higher irAE burden.
-
Cemiplimab, dostarlimab, tremelimumab
Cemiplimab for cutaneous SCC and NSCLC. Dostarlimab for dMMR endometrial and MSI-H solid tumours. Tremelimumab (anti-CTLA-4) in HCC and NSCLC combinations.
-
Relatlimab - anti-LAG-3
The first anti-LAG-3 antibody, given with nivolumab (Opdualag) for advanced melanoma. Lower toxicity than ipilimumab-nivolumab.
-
Red flag: active autoimmune disease
Active lupus, MS, inflammatory bowel disease, prior solid-organ transplant or ongoing high-dose steroids need careful MDT review before any checkpoint inhibitor.
Cancer types
The licensed indications, by tumour.
Neoadjuvant, adjuvant, first-line and later-line settings across the tumour types where checkpoint inhibitors now sit at the front of the treatment algorithm.
-
Melanoma
Adjuvant pembrolizumab or nivolumab after resection of stage IIB-IV. Advanced disease: nivolumab-relatlimab or nivolumab-ipilimumab for BRAF wild-type, or after targeted therapy.
-
Non-small cell lung cancer (NSCLC)
First-line pembrolizumab monotherapy if PD-L1 TPS >=50%. Pembrolizumab or atezolizumab with chemotherapy regardless of PD-L1. Durvalumab consolidation after chemoradiotherapy in stage III.
-
Renal cell carcinoma (RCC)
First-line nivolumab-ipilimumab (intermediate/poor risk), or pembrolizumab or nivolumab combined with a TKI (axitinib, cabozantinib, lenvatinib).
-
Urothelial cancer
First-line pembrolizumab-enfortumab vedotin. Maintenance avelumab after platinum. Adjuvant nivolumab after cystectomy for high-risk muscle-invasive disease.
-
Triple-negative breast cancer (TNBC)
PD-L1 CPS >=10 metastatic TNBC: pembrolizumab or atezolizumab with chemotherapy. Early-stage TNBC: neoadjuvant pembrolizumab-chemotherapy then adjuvant pembrolizumab (KEYNOTE-522).
-
Head and neck SCC
First-line pembrolizumab (mono if CPS >=1, or with chemotherapy) for recurrent or metastatic HNSCC. Second-line nivolumab after platinum failure.
-
Gastric, oesophageal, HCC, MSI-H
Nivolumab-chemotherapy for gastric/GOJ and oesophageal adenocarcinoma. Atezolizumab-bevacizumab for HCC. Pembrolizumab or dostarlimab for any MSI-H/dMMR solid tumour, tissue-agnostic.
-
Cervical, endometrial, cutaneous SCC, Merkel
Pembrolizumab-chemotherapy for cervical (CPS >=1). Dostarlimab-chemotherapy for advanced/recurrent endometrial. Cemiplimab for advanced cutaneous SCC. Avelumab or pembrolizumab for Merkel cell carcinoma.
Where we treat
A small panel of London oncology units, we picked them.
Bupa Cromwell Oncology, Royal Marsden Private, UCLH Private, HCA London Bridge, HCA The Wellington Oncology and, for northern patients, Christie Private in Manchester. Introductions are made privately once we understand your case.
Selection criteria
How we choose every unit and oncologist in our network.
-
Consultant medical oncologists with high checkpoint-inhibitor volumes and irAE experience
-
Dedicated infusion suites with same-day acute oncology cover for immune-related toxicity
-
On-site pathology and molecular profiling: PD-L1 (22C3, SP263), MSI/dMMR, TMB, HER2
-
MDT input including endocrinology, gastroenterology, hepatology and respiratory teams for irAE management
Immune-related adverse events
irAEs, and how they are managed - honestly.
Because checkpoint inhibitors take the brakes off your immune system, they can cause inflammation in any organ. Early recognition, prompt steroids and, where needed, biologics like infliximab or vedolizumab resolve most events.
-
Thyroiditis and hypothyroidism
The commonest irAE (10-20% with anti-PD-1). TFTs at baseline and before every cycle. Levothyroxine started if overt; no dose interruption needed for isolated thyroid change.
-
Immune colitis
Diarrhoea or abdominal pain in 5-15% (higher with ipilimumab combinations). Grade >=2 needs prompt oral or IV steroids, and infliximab or vedolizumab for steroid-refractory cases.
-
Pneumonitis
New cough, breathlessness or hypoxia in 3-5%. CT chest, hold treatment, high-dose prednisolone. Rechallenge only after grade 1 recovery and MDT review.
-
Hepatitis (immune-mediated)
Transaminitis in 5-10%. LFTs before every cycle. Steroids for grade >=2; mycophenolate for steroid-refractory. Avoid hepatotoxic drugs during flares.
-
Hypophysitis and adrenal insufficiency
Fatigue, headache, hypotension - most common with ipilimumab. Morning cortisol, ACTH, pituitary MRI. Lifelong hydrocortisone replacement is often required.
-
Dermatitis and pruritus
Rash and itch in 20-30%. Emollients, topical steroids and antihistamines usually suffice. Rare severe reactions (SJS/TEN) need immediate specialist review.
-
Myocarditis - rare but serious
Occurs in <1% but with high mortality. Baseline ECG and troponin, then troponin at cycle 2 for combinations. Any chest pain or arrhythmia stops treatment and triggers cardiology review.
-
Type 1 diabetes and other endocrinopathies
New hyperglycaemia can present as DKA. Fasting glucose at every cycle. Also watch for hypophysitis-driven adrenal crisis and rare hypoparathyroidism.
-
Red flags after infusion
Any new symptom lasting more than 48 hours (diarrhoea, cough, rash, headache, fatigue, chest pain) needs the 24/7 acute oncology line, not primary care.
Selection biomarkers
The four numbers that pick the right drug. Ask for them.
Checkpoint inhibitor selection is biomarker-led. Before any first cycle, we insist your tumour has been profiled for the markers that actually change the drug choice.
A quiet reminder
Immunotherapy without biomarker sign-off is the wrong start.
If your recent biopsy has not been tested for PD-L1, MSI/dMMR or TMB, we arrange it before quoting a course.
- 01 PD-L1
PD-L1 expression - CPS or TPS
Combined Positive Score (CPS) for HNSCC, gastric, cervical, urothelial and TNBC. Tumour Proportion Score (TPS) for NSCLC. Thresholds: >=1, >=10 or >=50 depending on indication and drug.
- 02 MSI/dMMR
Mismatch repair status
MSI-H (high microsatellite instability) or dMMR (loss of MLH1/MSH2/MSH6/PMS2) predicts strong response to pembrolizumab or dostarlimab in a tissue-agnostic way. Standard test in colorectal and endometrial cancers.
- 03 TMB
Tumour mutational burden
TMB-high (>=10 mutations per megabase) supports pembrolizumab in solid tumours without other treatment options. Measured on comprehensive NGS panels; interpret alongside PD-L1 and MSI.
- 04 HER2 / other
HER2, EBV and disease-specific markers
HER2 status refines gastric and oesophageal choices (pembrolizumab-trastuzumab-chemo for HER2+). EBV positivity in gastric predicts strong response. Driver mutations (EGFR, ALK) usually make single-agent immunotherapy inappropriate first-line.
Recognised by major UK insurers
Cover varies by insurer, drug and indication - annual drug caps can be exhausted on a 24-month course. We confirm cover and prior authorisation before booking.
Frequently asked
Everything we get asked about private immunotherapy.
Quick answers on outpatient logistics, side effects, insurance, course length, combination cost and MDT sign-off.
-
Is immunotherapy given as an outpatient?
Yes. Almost all checkpoint inhibitor infusions are outpatient day-case procedures. You arrive, have pre-cycle bloods and a review, receive the infusion over 30 to 60 minutes, and are observed for around 30 minutes afterwards. Total time in the unit is usually two to four hours. You do not need to stay overnight for a standard cycle.
-
Are the side effects manageable?
For most patients, yes. Anti-PD-1 or anti-PD-L1 monotherapy is well tolerated: fatigue, mild rash and thyroid changes are the commonest issues. Ipilimumab-containing combinations carry a materially higher immune-related toxicity burden - around 40-55% grade 3 to 4 adverse events. Early recognition and prompt steroids resolve most irAEs; a 24/7 acute oncology hotline is essential.
-
Does UK private medical insurance cover immunotherapy?
Cover varies. Bupa, AXA Health, Vitality, Aviva and WPA usually fund licensed checkpoint inhibitors for licensed indications, subject to policy limits and prior authorisation. Some policies cap annual drug spend, which can be exhausted quickly on a 24-month course. We confirm cover, drug caps and pre-authorisation before you start.
-
How long does a course of immunotherapy last?
Standard practice is 12 months for adjuvant treatment (for example, resected melanoma) and up to 24 months for advanced disease, or until disease progression or unmanageable toxicity - whichever comes first. Some patients who achieve a deep response stop earlier by MDT decision. Restaging CT at 9 to 12 weeks, then every 12 weeks, guides the plan.
-
How much does a full combination course cost privately?
A four-cycle ipilimumab plus nivolumab induction (for melanoma or RCC) followed by nivolumab maintenance for up to two years typically totals £90,000-£180,000, drug-dependent. Pembrolizumab monotherapy for two years is around £70,000-£110,000. Full course costs vary widely by drug, weight-based dosing, unit mark-up and whether combined with chemotherapy or a TKI.
-
Do I need an MDT decision before starting?
Yes. Every checkpoint inhibitor plan should be underwritten by a multi-disciplinary team decision: medical oncology, pathology (for PD-L1, MSI, HER2), radiology and, for many tumours, surgical and radiation oncology. We insist on documented MDT sign-off before the first cycle, whether that MDT sits inside the private unit or is convened jointly with your NHS team.
Ready to start
Send us the histology. We come back within one working day.
A named oncologist, an MDT-signed plan, a firm quote and insurer confirmation - before you commit to your first cycle.
Related treatments and tests
Looking for something else?
-
CAR-T cell therapy
Engineered T-cell therapy for haematological malignancies.
Learn more -
TIL therapy
Tumour-infiltrating lymphocyte therapy for advanced melanoma.
Learn more -
Bispecific antibody therapy
T-cell engagers for haematological and solid tumours.
Learn more -
Antibody-drug conjugate infusion
Targeted cytotoxic payloads via monoclonal antibodies.
Learn more -
Tumour molecular profiling
Comprehensive NGS with PD-L1, MSI, TMB and driver mutations.
Learn more -
ctDNA monitoring
Liquid-biopsy tracking of minimal residual disease and response.
Learn more -
Breast cancer
Full patient guide including PD-L1+ TNBC immunotherapy.
Learn more -
Colorectal cancer
MSI-H/dMMR pathways and checkpoint inhibitor options.
Learn more