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– After the use of immunocompetent drugs, the immune system, which so far “has not seen” cancer cells, because they were masked by certain substances and biological agents produced by them, begins to notice cancer cells and destroy them effectively – explains Prof. dr hab. n. med. Dariusz M. Kowalski, president of the Polish Lung Cancer Group. – It’s like restoring a blind man’s eyesight, a huge breakthrough in medicine – he adds.
- Lung cancer has been the most common cancer among men for years, both in terms of the number of cases and deaths. In women, it ranks second after breast cancer
- For many years, this cancer had a very poor prognosis. He was treated mainly by surgery, and chemotherapy usually extended the patient’s life by only a few months
- Two revolutions have been happening in the area of lung cancer treatment for several years. The first is the use of the so-called targeted therapy. The second – the introduction of immunotherapy – explains prof. Kowalski
- Unfortunately, modern forms of therapy are not available to all patients, they are reimbursed only in selected cases
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It should be emphasized that lung cancer has been the most common malignant neoplasm for many years. In the male population, this cancer ranks first in terms of morbidity and mortality. In contrast, in women, the opposite is true – lung cancer ranks second in terms of morbidity, but unfortunately, in first place in terms of mortality.
The epidemiological problem caused by lung cancer is enormous, because about 1,5 million new cases are diagnosed in the world each year, while in Poland about 22-23 thousand new cases are diagnosed.
- The most deadly cancer. 2 million new cases annually in Europe
Lung cancer requires very careful care of the patient. It is worth mentioning that it is a cancer that has been surrounded by an atmosphere of apathy and nihilism for many years. It was also a cancer with a very poor prognosis for many years, and the only method that offered a chance for a permanent cure or prolonged survival was mainly surgery. In turn, in patients with disseminated lung cancer, the only treatment method was chemotherapy, which was associated with various complications. Additionally – its effectiveness was quite low, because it extended the average survival time by an average of 6-7, sometimes 8 months.
Two revolutions in treatment
Over the past few years, we have witnessed a paradigm shift in the treatment of lung cancer. This applies in particular to non-small cell lung cancer, where the introduction of innovative drugs – molecularly targeted at specific genetic aberrations, i.e. drugs in the so-called targeted therapy – radically changed the medical approach and the fate of people suffering from lung cancer.
In addition, for several years we have witnessed another revolution in the treatment of this cancer, which is the introduction of immunotherapy, i.e. the use of immunocompetent drugs.
- It develops silently for up to 10 years. It gives symptoms that we do not associate with cancer
It is important to realize that immunocompetent drugs are not strict anti-cancer drugs. They do not directly destroy the cancer cells, but change the way the cancer patient’s immune system works. After the use of immunocompetent drugs, the immune system, which has so far “not seen” cancer cells because they were masked by certain substances and biological agents produced by them, begins to notice cancer cells and destroy them effectively. The action of immunocompetent drugs can therefore be compared to a therapy that restores the “blind man’s sight” – here, the blind is the immune system of a lung cancer patient.
Lung cancer as a chronic disease
Molecularly targeted drugs have altered the perception of lung cancer. For several years now, cancer, which we have so far talked about as an almost always fatal disease, can now be referred to as a chronic disease in relation to a fairly large population. This is because the average survival times of patients – even those with distant metastases – are much longer than 6-7 months. We can cure such sick people for years; of course, with a great quality of life.
Recently, an update of the results of a study indicating the effectiveness of immunotherapy in lung cancer has been published, which shows that the percentage of patients surviving 5 years and more is 32%. It is therefore a huge success, because until recently a patient with metastases survived only a year after classic therapy, and only in some cases it was 2 years.
Reimbursed immunotherapy is currently not for everyone
Currently, reimbursed first-line immunotherapy is used in a population of patients in whom the percentage of cancer cells containing a treatment response factor (cells expressing the PD-L1 protein) is 50%. and more, it is carried out as monotherapy with pembrolizumab, i.e. without the use of adjuvant chemotherapy. This treatment extends the average survival time of patients more than twice – for classic chemotherapy this time is 14 months, while after immunotherapy it is over 30 months.
- He asked the doctor if he would live. «You know, everyone has a chance, but with you …»
Unfortunately, only about 30% of patients can benefit from this method of treatment. patients with non-small cell lung cancer. What about other people with this form of cancer? For them, is classic chemotherapy the only first-line option? At the moment, in Poland – yes, due to the lack of access to the reimbursed drug program.
A group of patients in whom the percentage of cells containing a response factor to anticancer treatment is less than 50%. (PD-L1 expression
The implementation of further therapies in Poland is currently the responsibility of the Ministry of Health and the National Health Fund, because modern drug programs dedicated to patients with lung cancer have received a positive note from the Agency for Health Technology Assessment and Tariffs. I hope that further modifications of the drug program will lead to the fact that modern procedures will be available to many patients with lung cancer.
The article comes from the campaign “W trosce o seniów” prepared by Warsaw Press, and the media partner of which is MedTvoiLokony. All materials can be found on http://seniorzy.warsawpress.com/
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