IMMUNOTHERAPY AND TOXICITY MANAGEMENT IN PATIENTS WITH NON-SMALL CELL LUNG CANCER

2021 ◽  
Vol 0 (39) ◽  
pp. 0-0
Author(s):  
Necmiye ÇÖMLEKÇİ ◽  
Dilek BAYKAL
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Retrospective Studies ◽  
Web Of Science ◽  
Early Period ◽  
Small Cell ◽  
Endocrine Disorders ◽  
Small Cell Lung ◽  
Skin Reactions

Aim: The aim of this review is to present an overview of the management of toxicities commonly seen in immunotherapy in patients with non-small cell lung cancer. Methods: “non-small cell lung cancer” OR “NSCLC” AND “PD-1” OR “PD-L1” AND from PubMed, Google Scholar, Web of Science databases to identify common toxicities based on the results of studies with patients with non-small cell lung cancer. A search was made with the keywords “retrospective”. Findings: A total of 12 retrospective studies with full texts in English were analyzed. According to the results of the study, it was found that toxicities such as skin reactions, pneumonitis, diarrhea, endocrine disorders, hepatitis, renal toxicity, neurotoxicity and atralgis were developed. Conclusions: In patients with non-small cell lung cancer receiving immunotherapy, it is important to detect toxicities in the early period so that the treatment continues without disruption. Oncology nurses have important roles in the prevent and early detection of toxicities, the education of the patient and their family, and the morning and evaluation of toxicity symptoms.

Vaccination of patients with advanced non-small cell lung cancer with an optimized cryptic hTERT peptide (Vx-001)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7642-7642
Author(s):  
K. Kosmatopoulos ◽  
E. Bolonaki ◽  
A. Kotsakis ◽  
E. Papadimitraki ◽  
D. Agouraki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Median Overall Survival ◽  
Small Cell ◽  
Historical Control ◽  
Small Cell Lung ◽  
Skin Reactions ◽  
Local Skin

7642 Background: To evaluate the immunological and clinical efficacy of the optimized peptide TERT572Y (Vx-001) presented by HLA-A*0201 in patients with advanced non-small cell lung cancer (NSCLC). Methods: Twenty-two patients with residual (n=8) or progressive (n=14) advanced NSCLC following chemotherapy and/or radiotherapy received two subcutaneous injections of the optimized TERT572Y peptide followed by four injections of the native TERT572 peptide given every 3 weeks. Peptide-specific immune responses were monitored by Elispot assay and/or TERT572Y pentamer staining. Clinical outcome was compared with that of 22 case-matched historical control patients. Results: Thirteen (59%) out of 22 patients completed the vaccination program. Toxicity consisted primarily of local skin reactions. TERT572-specific CD8+ cells were detected in 16 (76.2%) out of 21 patients after the 2nd vaccination and 10 (90.9%) out of 11 patients after the 6th vaccination. Stable disease occurred in 8 (36.4%) patients with a median duration of 11.2 months. Patients with an early immunological response (n=16) had a significantly longer time to disease progression and overall survival than non-responders (n=5) (log-rank tests p=0.046 and p=0.012, respectively). The estimated median overall survival was 30.0 (range, 2.8–40.0) and 4.1 (range, 2.4–10.9) months for immunological responders and non-responders, respectively. Moreover, median overall survival was 30.6 months (95% CI:10.9–48.9) and 6.1 months (95% CI:4.4–7.8) for the vaccinated and case-matched historical control patients, respectively (p=0.074). Conclusions: TERT572Y peptide vaccine is well tolerated and effective in eliciting a specific T-cell immunity which seems to be associated with prolonged patients’ survival. No significant financial relationships to disclose.

scholarly journals Characterization of nivolumab-associated skin reactions in patients with metastatic non-small cell lung cancer

2016 ◽  
Vol 5 (11) ◽  
pp. e1231292 ◽  
Author(s):  
Omar Hasan Ali ◽  
Stefan Diem ◽  
Eva Markert ◽  
Wolfram Jochum ◽  
Katrin Kerl ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Skin Reactions

scholarly journals Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Howard (Jack) West ◽  
Yuan Angela Tan ◽  
Afsaneh Barzi ◽  
Debra Wong ◽  
Robert Parsley ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Medical Records ◽  
Early Period ◽  
Cost Savings ◽  
Small Cell ◽  
Evidence Based ◽  
Case Review ◽  
Small Cell Lung

PURPOSE: AccessHope is a program developed initially by City of Hope to provide remote subspecialist input on cancer care for patients as a supplemental benefit for specific payers or employers. The leading platform for this work has been an asynchronous model of review of medical records followed by a detailed assessment of past and current management along with discussion of potential future options in a report sent to the local oncologist. This summary describes an early period of development and growth of this service, focusing on cases of lung cancer, particularly during the COVID-19 pandemic. METHODS: Cases were primarily identified by a trigger list of cancer diagnoses that included non–small-cell lung cancer and small-cell lung cancer. After medical records were obtained, a summary narrative was provided to a thoracic oncology specialist who wrote a case review sent to the local physician, followed by a direct discussion with the recipient. We focused on feasibility as measured by case volumes, the rates of concordance between the subspecialist reviewer with the local team, and cost savings from recommended changes, using descriptive statistics. RESULTS: From April 2019 to November 2020, 110 cases were reviewed: 55% male, median age 62.5 years (range, 33-92 years); 82% non–small-cell lung cancer (12% stage I or II, 16% stage III, and 57% stage IV), and 17% small-cell lung cancer (4% limited and 14% extensive). Median turnaround time for report send-out was 5.0 days. The review agreed with local management in 79 (72%) cases and disagreed in 31 (28%) cases; notably, specific additional recommendations were associated with evidence-based anticipated improvements in efficacy in 76 cases (69%) and improvement in potential for cure in 14 cases (13%). Recommendations leading to cost savings were identified in 14 cases (13%), translating to a projected cost savings of $19,062 (USD) per patient for the entire cohort of patient cases reviewed. CONCLUSION: We demonstrate the feasibility of completing a rapid turnaround of cases of lung cancer either patient-initiated for review or prospectively triggered by diagnosis and stage. This program of asynchronous second opinions identified evidence-based management changes affecting current treatment in 28% and potential improvements to improve care in 92% of patients, along with cost savings realized by eliminating low-value interventions.

Vaccination of Patients With Advanced Non–Small-Cell Lung Cancer With an Optimized Cryptic Human Telomerase Reverse Transcriptase Peptide

2007 ◽  
Vol 25 (19) ◽  
pp. 2727-2734 ◽  
Author(s):  
Irini Bolonaki ◽  
Athanassios Kotsakis ◽  
Elsa Papadimitraki ◽  
Despoina Aggouraki ◽  
George Konsolakis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Reverse Transcriptase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Immunological Response ◽  
Small Cell ◽  
Telomerase Reverse Transcriptase ◽  
Small Cell Lung ◽  
Skin Reactions ◽  
Local Skin

PurposeTo evaluate the immunological and clinical response as well as the safety of the optimized peptide telomerase reverse transcriptase p572Y (TERT572Y) presented by HLA-A*0201 in patients with advanced non–small-cell lung cancer (NSCLC).Patients and MethodsTwenty-two patients with advanced NSCLC and residual (n = 8) or progressive disease (PD; n = 14) following chemotherapy and/or radiotherapy received two subcutaneous injections of the optimized TERT572Ypeptide followed by four injections of the native TERT572peptide administered every 3 weeks. Peptide-specific immune responses were monitored by enzyme-linked immunosorbent spot assay and/or TERT572Ypentamer staining.ResultsTwelve (54.5%) of 22 patients completed the vaccination program. Toxicity consisted primarily of local skin reactions. TERT572-specific CD8+cells were detected in 16 (76.2%) of 21 patients after the second vaccination, and 10 (90.9%) of 11 patients after the sixth vaccination. Stable disease (SD) occurred in eight (36.4%) of 22 vaccinated patients, with three (13.6%) having had PD before entering the study. The median duration of SD was 11.2 months. After a median follow-up of 10.0 months, patients with early developed immunological response (n = 16) had a significantly longer time to progression and overall survival (OS) than nonresponders (n = 5; log-rank tests P = .046 and P = .012, respectively). The estimated median OS was 30.0 months (range, 2.8 to 40.0 months) and 4.1 months (range, 2.4 to 10.9 months) for responders and nonresponders, respectively.ConclusionTERT572Ypeptide vaccine is well tolerated and effective in eliciting a specific T cell immunity. Immunological response is associated with prolonged survival. These results are encouraging and warrant further evaluation in a randomized study.

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