Immunotherapy in first-line treatment of recurrent non-small cell lung cancer
https://doi.org/10.21518/2079-701X-2019-19-132-136
Abstract
For a long time, the standards of first-line drug therapy for patients with advanced non-small-cell lung cancer (NSCLC), excluding cases of mutations of EGFR, ALK and ROS1, were platinum-containing regimens. However, the chemotherapeutic regimes used in the therapy of the first line therapy of NSCLC have insignificant efficiency, and therefore the total survival rate of patients remains low: the response rate varies from 12 to 37%, the median survival rate without progression is from 4 to 7 months, the median of total survival – from 8 to 13 months.
The use of a new class of immunooncologic drugs called immune checkpoint inhibitors has expanded the treatment options for NSCLC patients. One of the most effective immunooncologic drugs is pembrolizumab, which showed a clear advantage in increasing the overall survival rate in comparison with chemotherapy – median was 30.0 months vs. 14.2 months. (RR 0,63; 95% CI: 0,47–0,86; р = 0,002).
The article presents the clinical observation of a patient with the diagnosis of «adenocarcinoma of the upper part of the right lung of the IIIA stage» with the progression developed in two years after the combined treatment. The patient received 29 courses of pembrolizumab immunotherapy in the first line of therapy with partial response achievement.
The presented clinical observation confirms the efficacy of pembrolizumab in the first line of NSCLC treatment. Due to the immunotherapy with pembrolizumab there is no progression of the disease during more than 22 months with satisfactory quality of life and absence of pronounced toxicity of treatment.
The use of a new class of immunooncologic drugs called immune checkpoint inhibitors has expanded the treatment options for NSCLC patients. One of the most effective immunooncologic drugs is pembrolizumab, which showed a clear advantage in increasing the overall survival rate in comparison with chemotherapy – median was 30.0 months vs. 14.2 months. (RR 0,63; 95% CI: 0,47–0,86; р = 0,002).
The article presents the clinical observation of a patient with the diagnosis of «adenocarcinoma of the upper part of the right lung of the IIIA stage» with the progression developed in two years after the combined treatment. The patient received 29 courses of pembrolizumab immunotherapy in the first line of therapy with partial response achievement.
The presented clinical observation confirms the efficacy of pembrolizumab in the first line of NSCLC treatment. Due to the immunotherapy with pembrolizumab there is no progression of the disease during more than 22 months with satisfactory quality of life and absence of pronounced toxicity of treatment.
About the Authors
E. O. Rodionov
Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center» of the Russian Academy of Sciences;
Russian Federation
Russian Federation
Cand. of Sci. (Med), Senior Researcher of the Department of Thoracic Oncology, Research Institute of Oncology; Assistant at the Department of Oncology
SPIN-сode: 7650-2129, AuthorID: 805452, ResearcherID: B-7280-2017, SCOPUS: 57189622130
12/1, Savinykh st. Tomsk, 634028, Russia
2, Moskovskiy Hwy., Tomsk, 634050, Russia
S. V. Miller
Research Institute of Oncology, Federal State
Budgetary Scientific Institution «Tomsk National Research Medical Center» of the Russian Academy of Sciences
Russian Federation
Russian Federation
Dr. of Sci. (Med), Head Researcher of the Department of Thoracic Oncology
SPIN-code: 6510-9849, AuthorID: 558789, ResearcherID: C-8970-2012, SCOPUS: 56525429400
12/1, Savinykh st. Tomsk, 634028, Russia
S. A. Tuzikov
Research Institute of Oncology, Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center» of the Russian Academy of Sciences;
Federal State Budgetary Educational Institution of Higher Education «Siberian State Medical University» of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med), Head of the Department of Thoracic Oncology,
Professor of the Department of Oncology
12/1, Savinykh st. Tomsk, 634028, Russia
2, Moskovskiy Hwy., Tomsk, 634050, Russia;
SPIN-code: 5662-6431, AuthorID: 455003, ResearcherID: D-1176-2012, SCOPUS: 6507842873
L. A. Efteev
Research Institute of Oncology, Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center» of the Russian Academy of Sciences
Russian Federation
Russian Federation
Junior Researcher of the Department of Thoracic Oncology
12/1, Savinykh st. Tomsk, 634028, Russia
SPIN-code: 3474-4654, AuthorID: 978000
V. A. Markovich
Research Institute of Oncology, Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center» of the Russian Academy of Sciences
Russian Federation
Russian Federation
Junior Researcher of the Department of Thoracic Oncology
12/1, Savinykh st. Tomsk, 634028, Russia;
SPIN-code: 2954-8330, AuthorID: 968514
D. S. Miller
Federal State Budgetary Educational Institution of Higher Education «Siberian State Medical University» of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
4th year medical student
2, Moskovskiy Hwy., Tomsk, 634050, Russia
SPIN: 3384-4789
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Review
For citations:
Rodionov EO, Miller SV, Tuzikov SA, Efteev LA, Markovich VA, Miller DS. Immunotherapy in first-line treatment of recurrent non-small cell lung cancer. Meditsinskiy sovet = Medical Council. 2019;(19):132-136. (In Russ.) https://doi.org/10.21518/2079-701X-2019-19-132-136
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