Health New treatment for the most advanced lung cancer

Health
New treatment for the most advanced lung cancer

MARCH 28, 2017 - 22:26 For oncologists it is a paradigm shift because it involves treating it when it is at a metastatic level with immunotherapy and without chemotherapy.

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New treatment for the most advanced lung cancer
Although it is clear that tobacco causes lung cancer, smoking continues to increase.

The National Administration of Medicines, Foods and Medical Technology (Anmat) approved the first immunotherapy for the initial treatment of more advanced lung cancer. This is the immuno-oncological drug pembrolizumab for the treatment of patients with advanced non-small cell lung carcinoma (NSCLC), whose tumor has a high expression of the PD-L1 protein, that is, 50% or more of the cells tumors - determined by a validated trial. As explained, it is a monoclonal antibody designed to bind to the receptor called PD-1 and enhance antitumor immunity. Lung cancer is one of the most lethal, especially if diagnosed late, and is the most common malignant tumor worldwide. It originates from the epithelial cells of the lung and usually invades neighboring structures and metastasizes to other parts of the body. The most frequent symptoms are usually respiratory distress, cough (sometimes accompanied by bloody expectoration) and weight loss, as well as chest pain and hoarseness, among others. In turn, lung cancer is classified into two main types depending on the appearance of the malignant cells and their clinical behavior: small cell lung cancer (small cell lung cancer) and non-small cell lung cancer (non-small cell). This distinction conditions the treatment, so pembrolizumab is indicated for those of the second type, that is, those of non-small cells, which constitute 85% of all cases of lung cancer. According to the results of the Keynote 024 study, a comparative clinical trial between pembrolizumab and standard chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) with high expression of PD-L1 protein and without prior treatment, Results were better in favor of immunotherapy in regard to survival without progression of the disease, overall survival and response rate. "This drug showed, compared to conventional chemo, a higher estimated response rate in the absolute 17%, reducing the risk of death by 40% and the risk of disease progression by 50% a year after the start of treatment. "Said Javier de Castro Carpeño, head of the Lung Cancer Unit of the La Paz University Hospital in Madrid. The Spanish specialist indicated that "the best thing is that all of this with 50% less adverse effects and improving the quality of life for patients due to having a very acceptable toxicity profile". Biomarking, which in this case is based on the search for expression of PD-L1 in the tumor, plays a fundamental role in this immunological therapy, since it will indicate which group of patients will benefit from the therapy, representing an economic benefit for the patients. Systems of health. According to Claudia Bagnes, Head of Oncology at Hospital Tornú: "Biomarking is key since tumors use multiple mechanisms to trick the immune system, such as the expression of the PD-L1 marker on its surface, which puts a brake on T lymphocytes. , preventing the latter from attacking them. Thanks to these new drugs, it is now possible to identify and remove this barrier that the tumor put on the immune system. "

Change

In August 2016, Anmat approved the drug in Argentina as a second-line treatment, while the Food and Drug Administration of the United States and the European Medicines Agency authorized it as a first-line treatment worldwide. "For oncologists is a paradigm shift, it is a great advance to treat metastatic lung cancer with immunotherapy and without chemotherapy, which was completely unimaginable just a few years ago," assessed Castro Carpeño, University Hospital La Paz in Madrid.