Immune oncology (IO) and metastatic lung cancer [CBD]: Curability, bony metastasis and duration of therapy
| Autor: | Yadav Pandey, A. Mazin Safar, Eric J. Del Giacco, Hunter C Cochran, Richard W. Nicholas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty Bone disease Immune checkpoint inhibitors medicine.medical_treatment Cancer therapy Pembrolizumab Duration of immunetherapy immune checkpoint inhibitors Immune system Internal medicine medicine RC254-282 General Environmental Science bone metastasis business.industry General Engineering Neoplasms. Tumors. Oncology. Including cancer and carcinogens Immunotherapy medicine.disease Immune oncology Bony metastasis General Earth and Planetary Sciences Metastatic lung cancer business Cure |
| Zdroj: | Current Problems in Cancer: Case Reports, Vol 4, Iss, Pp 100129-(2021) |
| ISSN: | 2666-6219 |
| Popis: | The introduction of immune checkpoint inhibitors (ICI) instigated significant improvement in the management of metastatic NSCLC. Currently, metastatic NSCLC remains in the category of ‘incurable’ malignancies and there is no biologic or mechanistic basis to guide the duration of treatment with immunotherapy. Generally, ICIs are continued until progression, unacceptable toxicity occurs or for an arbitrary 2 years. We present a case of stage IV NSCLC with bulky disease and several adverse prognostic factors who demonstrated remarkable benefits, arguably amounting to cure using a much shorter pembrolizumab course (4 months) and has remained free of progression off cancer therapy for 42 months. This case raises several important points regarding the current treatment approach and objective in metastatic NSCLC. Moreover, we argue that the management of metastatic bone disease may need reconsideration when immunotherapy is used considering the known adverse impact of radiation on immune cells. Lastly, we propose the consideration of c-reactive protein as a putative marker which may function as an objective tracer of metastatic activity providing the oncologist with a useful tool in managing such patients with ICI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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