Immunotherapy in the treatment of lung cancer

Abstract:

The use of immunotherapy is considered to be the greatest advancement in the treatment of lung cancer in the past few years. Immune checkpoint inhibitors are used for controlling the immune reactions on tumor cells, and directing these reactions to their activation. So far, the following immune checkpoint molecules exist: ipilimumab, antibody to CTLA-4; nivolumab and atezolizumab, antibodies to PD-L1; and pembrolizumab, antibody to PD1. Considering the results from current studies, pembrolizumab is recommended in the first line of treatment in patients with non-small cell lung carcinoma with a PD-L1 expression greater than 50%, while immunotherapy with checkpoint inhibitors are a standard-of-care in the second line of treatment. Nivolumab and atezolizumab are registered regardless of the PD-L1 status, while pembrolizumab is registered for PD-L1 positive patients. Side-effects related to immunotherapy are less common than side-effects related to chemotherapy. Treatment depends on the severity of side-effects, and consists of the delay or discontinuation of immunotherapy and immunosuppressive medications.

Key words:
Lung cancer; Immune Checkpoint Inhibitors; Immunotherapy; Immunotherapy, Side effects