Lung cancer immunotherapy
Progressive immunotherapy for lung cancer in Israel – Opdivo, Keytruda, Tecentriq, Yervoi, T-cell therapy TIL, Avastin, Vargatef, Cyramza, Tarceva, Iressa, Giottrif, Tagrisso, Portrazza, Alunbrig
Immunotherapy of lung cancer is the treatment with drugs that stimulate the patient’s immune system. The antibodies that are contained in the medicines “train” the body so that it attacks and destroys cancer cells, which is very effective in lung cancer treatment.
This innovative treatment, approved by the FDA in 2015, in recent years, significantly improves the prognosis for patients with lung cancer and leads to an increase in their survival in Israel.
20-25% of patients with lung cancer are now long-term survivors, thanks to immunotherapy.
Currently, several immunotherapeutic drugs for the treatment of lung cancer have been approved:
– Bevacizumab (Avastin)
– Neutzitumum (Portrazza)
– Ramucirumab (Cyramza)
Check Point Inhibitors:
These drugs are used as first-line therapy for patients with metastatic lung cancer, and are also used in the personalized treatment of lung cancer based on molecular genomic tests in Israel.
Who is suitable for immunotherapy?
The best candidates for this treatment are patients with non-small cell lung cancer (NSCLC), which is diagnosed in 80-85% of cases. This type of lung cancer is found in former or current smokers, although it is also among non-smokers. This disease is also more common among women and youth.
Immunotherapy drugs are administered intravenously, once every two to three weeks. Because this is a new treatment, there is no standard time frame for treatment, and the progress of each patient is considered separately.
Immunotherapy drugs are aimed at “individual growth antigens”, which are expressed by cancer cells, and are defined by the medication as abnormal.
MAGE-3 is an antigen that accounts for 42% of lung cancer, and the NY-ESO1 antigen is present in about 30% of lung cancers. These goals provide promising approaches to new vaccines against lung cancer.
Immunotherapy shows very promising results:
Immunotherapy improves outcome in the treatment of metastatic lung cancer. As the first line of treatment, it is used in combination with chemotherapy, targeted therapy or other immunotherapy.
Some patients with metastatic lung cancer have achieved results of tumor extinction. They do not suffer from pain, dyspnea, and their computer tomography is clean.
More details about immunotherapy for the treatment of lung cancer
Biological drugs use natural substances designed to fight cancer cells of the lung in a mechanism specific for these cells. Immunotherapy drugs differ from chemical drugs (based on substances not natural to the body, but which affect cell division as a whole and, consequently, affect healthy cells).
The immune system of the body, consisting of white blood cells and tissues of the lymphatic system, functions to fight and destroy bacteria that penetrate the body. Immunotherapeutic drugs for the treatment of lung cancer NSCLC demonstrate high efficacy in medical research. These drugs stimulate selective activation of the body’s natural immune system to fight tumor growth that spreads in the lungs and other organs. Such drugs usually come into force 6-4 weeks after the natural immune system of the body has recovered and began to act independently against malignant growth.
Progressive immunotherapy for lung cancer (ODDIVO, KITRUDA, TENCENTRIC, YERVOI, TIL-TIL-TILE TREATMENT)
The immune system of the body, consisting of white blood cells and tissues of the lymphatic system, functions to fight and destroy pests that penetrate the body. Immunotherapeutic drugs for the treatment of lung cancer NSCLC demonstrate high efficacy in medical research. These drugs stimulate selective activation of the body’s natural immune system to combat tumor growth that spreads in the lungs and other organs. Such drugs usually come into force 6-4 weeks after the natural immune system of the body has recovered and began to act independently against malignant growth.
1. Receptors PD-1 inhibitors
Each cell of the body’s natural immune system is provided with receptors that allow them to destroy cells (apoptosis) under extreme conditions. Malignant tumor cells tend to bind to the PD-1 receptor (the full name is Programmed Death Receptor 1) and to stimulate receptors to destroy immune cells. Thus, a cancerous tumor can spread in the body without interfering with the immune system. Drugs of this group block the PD-1 receptor, preventing the cancer cell from connecting to it. In this situation, the cells of the immune system do not collapse and can fight the growing tumor.
In recent years, various preparations have been developed to block the PD-1 receptor in part by blocking one ligand (PD-L1) or completely by blocking two ligands (PD-L2). In recent years, these drugs have shown a high level of effectiveness in the treatment of NSCLC, as well as other cancers, including melanoma, breast cancer, stomach cancer, head and neck cancer and some tumors of blood cancer and lymph nodes.
To date, studies have been conducted to evaluate the effectiveness of the drug in the treatment of cancer patients with certain genetic mutations, including gene mutation in the protein PD-L1. In addition, studies are being conducted to evaluate the therapeutic efficacy of a combination of several drugs from this group.
• Opdivo preparation containing the active ingredient Nivolumab is an innovative immunotherapy preparation that is a monoclonal antibody that possesses a unique ability to activate the body’s natural immune system by blocking the PD-1 receptor. This drug has recently showed efficacy in the treatment of lung cancer NSCLC.
In March 2015, Optivo was the first drug in the group of progressive immunotherapy approved by the FDA (USA) for the treatment of patients with non-small cell lung cancer (NSCLC). In October 2015, the drug was also approved for patients who do not have squamous NSCLC. The drug was approved for all patients with metastatic lung cancer of NSCLC whose disease progressed during or after treatment with platinum-based chemotherapy, without the need for mutations in the PD-L1 gene.
• Keytruda, containing the active ingredient Pembolizumab, is another drug that is a monoclonal antibody that has the ability to activate the body’s natural immune system by blocking the PD-1 receptor. This drug has shown efficacy in the treatment of lung cancer (NSCLC).
In May 2017, the FDA approved the Keytruda for all patients with progressive malignancy in any area of the body, including the lungs – if the tumor was positive for the MSI-H biomarker, indicating “high genomic instability,” dMMR, indicating a defective mechanism for DNA repair .
2. Receptors PD-L1 inhibitors
• Tecentriq containing the active ingredient Aetzolizumab is an immunotherapy medicine approved by the FDA in May 2016 as a treatment for bladder cancer after failure of chemotherapy and / or radiation therapy. And in October 2016, the American Administration for the Treatment of Metastatic Non-Small Cell Lung Cancer included it for the treatment of lung cancer, which progressed despite treatment with platinum-based chemotherapy.
The drug is a monoclonal antibody with unique activity to activate the body’s natural immune system, blocking the receptor PD-L1 on a cancerous tumor. It is different from drugs that block the PD-1 receptor.
3. Receptor CTLA-4 inhibitors
• Yervoi drug containing the active ingredient Ipilimumab is another immunotherapy drug that is a monoclonal antibody with a unique ability to activate the body’s natural immune system by blocking the receptor CTLA-4. As CTLA-4 is a target for the drug, when it binds to the receptor, it stimulates the cell to attack and destroy cancer cells.
In recent years, the drug has been provided to treat patients with lung cancer (NSCLC) in Israel as part of the study and proved effective.
4. Treatment with T-cells (TIL therapy). This is a method of immunotherapy, in which T cells are removed from a patient with lung cancer, and then subjected to a special process of “reengineering” to detect and destroy cancer cells. This method has yielded promising results in the treatment of certain types of leukemia and lymphoma, and several cancers, including lung cancer, are currently being tested.