Peranan Immunoterapi Pada Kanker Paru

Abstrak. Kanker paru masih menjadi masalah kesehatan secara menyeluruh, baik di dunia maupun di Indonesia, khususnya di Aceh. Saat ini kanker paru masih menjadi penyebab kematian tertinggi di dunia. Berbagai peneletian tentang tatalaksana kanker paru telah dikembangkan, perkembangan terapi kanker paru saat ini berupa immunoterapi yang menargetkan reseptor penghambat sel T, seperti program sel death (PD-1) , terapi checkpoint blockade, immunoterapi baru berdasarkan neoantigen selektif dengan tujuan pengobatan mampu mendorong sel yang di transformasikan.Immunoterapi adalah salah satu metode pengobatan berbagai jenis tumor dengan efek samping yang dapat di atasi. Tujuan imunoterapi kanker adalah memberikan efektor antitumor (antibodi dan sel T ) terhadap pasien. Perkembangan ilmu pengetahuan tentang tatalaksana kanker berkembang sangat pesat, baik yang bersifat invasif maupun yang non invasif hingga penatalaksaan nano molekul. Tujuan pengobatan beruapa peningkatan kualitas hidup dan peningkatan survival rate.Kata Kunci : kanker paru, immunoterapi, PD-1, PD-L1, checkpoint blockadeAbstract. Lung cancer is still a comprehensive health problem, both in the world and in Indonesia, especially in Aceh. Currently lung cancer is still the highest cause of death in the world. Various studies on the management of lung cancer have been developed, the development of lung cancer therapy currently in the form of immunotherapy that targets T cell receptor inhibitors, such as the cell death program (PD-1), checkpoint blockade therapy, new immunotherapy based on selective neoantigens with the aim of treatment being able to encourage cells that transformed.Immunotherapy is one method of treating various types of tumors with side effects that can be overcome. The aim of cancer immunotherapy is to provide antitumor effectors (antibodies and T cells) to patients. The development of science about cancer management is developing very rapidly, both invasive and non-invasive to the management of nano molecules. Treatment goals include improving the quality of life and increasing survival rates.Keyword: lung cancer, immunotherapy, PD-1, PD-L1, checkpoint blockade

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Imaging Biomarkers of Tumour Proliferation and Invasion for Personalised Lung Cancer Therapy

Journal of Personalized Medicine ◽

10.3390/jpm10040222 ◽

2020 ◽

Vol 10 (4) ◽

pp. 222

Author(s):

Loredana G. Marcu

Keyword(s):

Lung Cancer ◽

Cancer Therapy ◽

Cancer Treatment ◽

Critical Role ◽

Imaging Biomarkers ◽

Lung Cancer Treatment ◽

Cancer Management ◽

Specificity And Sensitivity ◽

Lung Cancer Therapy ◽

Tumour Proliferation

Personalised treatment in oncology has seen great developments over the last decade, due to both technological advances and more in-depth knowledge of radiobiological processes occurring in tumours. Lung cancer therapy is no exception, as new molecular targets have been identified to further increase treatment specificity and sensitivity. Yet, tumour resistance to treatment is still one of the main reasons for treatment failure. This is due to a number of factors, among which tumour proliferation, the presence of cancer stem cells and the metastatic potential of the primary tumour are key features that require better controlling to further improve cancer management in general, and lung cancer treatment in particular. Imaging biomarkers play a key role in the identification of biological particularities within tumours and therefore are an important component of treatment personalisation in radiotherapy. Imaging techniques such as PET, SPECT, MRI that employ tumour-specific biomarkers already play a critical role in patient stratification towards individualized treatment. The aim of the current paper is to describe the radiobiological challenges of lung cancer treatment in relation to the latest imaging biomarkers that can aid in the identification of hostile cellular features for further treatment adaptation and tailoring to the individual patient’s needs.

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Urinary markers in treatment monitoring of lung cancer patients with bone metastasis

The International Journal of Biological Markers ◽

10.1177/1724600819848762 ◽

2019 ◽

Vol 34 (3) ◽

pp. 243-250

Author(s):

Pei Cheng Jin ◽

Bo Gou ◽

Wei Qian

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Bone Metastasis ◽

Kinase Inhibitors ◽

Growth Factor Receptor ◽

Background Level ◽

Driver Mutations ◽

Urinary Markers ◽

Cancer Management ◽

Non Invasive

Background: Bone metastasis remains critical for advanced stage non-small cell lung cancer (NSCLC)—a disease that is challenging to manage. Urinary markers present opportunities for non-invasive testing. Methods: Urine specimens were collected from patients prior to treatment. Urinary cell-free DNA was subsequently purified from these samples. To address the specificity of the test, driver mutations in epidermal growth factor receptor L858R and L861Q were analyzed. Clinical specificity was established by comparison with healthy volunteers. Regular monitoring was established during treatment with tyrosine kinase inhibitors. The overall survival of patients was correlated with changes in circulating tumor DNA (ctDNA). Results: Baseline clinical correlation of urinary ctDNA and matched tumor specimens achieved 89% concordance. The clinical specificity was 100%. The average background level of urinary ctDNA was 20.7 ng/mL. Comparing patients with and without bone metastasis, the latter had significantly lower baseline levels. During treatment, more pronounced decline in urinary ctDNA was observed in patients without bone metastasis. In our Kaplan–Meier estimator, we observed that patients with a more significant reduction in ctDNA had a better overall survival outcome. Conclusion: Our study demonstrates clear benefits and allows better risk profiling for NSCLC patients with bone metastasis. The non-invasive specimen collection is attractive and complements existing cancer management tools.

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A novel noninvasive biomarker based on peripheral PD-1posi CD8 T-cell receptor repertoire correlated with clinical outcomes to immunotherapy in non-small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e14174 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e14174-e14174

Author(s):

Jie-Fei Han ◽

Zhijie Wang ◽

Hua Bai ◽

Si Chen ◽

Yuqi Wang ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Clinical Outcomes ◽

Cell Lung Cancer ◽

Cell Receptor ◽

Small Cell ◽

Small Cell Lung ◽

Non Invasive ◽

Tcr Repertoire ◽

Tcr Diversity

e14174 Background: Although advances on exploration of biomarkers personalized the immune checkpoint blockades (ICBs) delivery, non-invasive blood-based approach remainsan intriguing area for further investigation.This study investigated the feasibility of peripheral isolated PD-1posiCD8T cell receptor (TCR) repertoire profiling in predicting the clinical outcomes of ICBs treatment for non-small cell lung cancer (NSCLC) patients. Methods: The study comprised two independent cohorts (A and B), ultimately recruiting total 40 from 51 patients with stage IIIB-IV NSCLCs who received anti-PD-1/PD-L1 therapy between March 14, 2017 and May 2, 2018. Peripheral blood samples of pre- and post-ICBs (the timepoint of first imaging evaluation) were prospectively collected, and PD-1posiCD8 T cells were isolated by flow cytometry for TCR sequencing. The diversity and clonality of the TCR repertoire were calculated for biomarker profiling. Cohort A (n = 25) was used as a training set for discovery of TCR diversity in the prediction of response to ICBs, and cohort B (n = 15) as a validation set. Progression-free survival (PFS) and response to ICBs treatment were correlated with TCR diversity and clonality. Results: In cohort A, patients with high pre-ICBs PD-1posiCD8 TCR diversity had longer PFS than those with low diversity (6.5 vs. 2.6 months, p = .045), which were substantially validated in cohort B. By using the incorporated set, pre-ICBs PD-1posiCD8 TCR diversity exhibited an optimal Youden's index of 0.81 with a sensitivity of 0.87 and a specificity of 0.94 in clarifying clinical response of ICBs (PR+SD vs. PD). Patients with increased PD-1posiCD8 TCR clonality demonstrated significantly improved PFS (7.3 vs. 2.7 months, p = .005) compared to those with decreased TCR clonality. Interestingly, two patients with initial pseudo-PD exhibited similar change of TCR clonality and expansion of dominant TCR clones with those with PR, but not PD. Conclusions: Peripheral PD-1posiCD8 TCR repertoire sequencing might be a promising non-invasive approach for selecting patients who could benefit from ICBs treatment, which guaranteed the further investigation and validation by larger cohorts.

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Lung cancer management in the COVID-19 pandemic

Journal of İzmir Chest Hospital ◽

10.5222/igh.2020.52714 ◽

2020 ◽

Author(s):

Murat Akyol ◽

Berna Kömürcüoğlu

Keyword(s):

Lung Cancer ◽

Intensive Care ◽

Clinical Picture ◽

Intensive Care Admission ◽

Cancer Management ◽

Non Invasive ◽

Secondary Infections ◽

Increased Risk ◽

Severe Clinical Picture ◽

Radiological Methods

Covid-19 infection, spreading from China to the whole world, continues to spread and cause serious mortality. Covid-19 infection causes mortality with pneumonia due to severe lung involvement, ARDS and respiratory failure. Lung cancer causes both a decrease in the local resistance of the lung and an increased risk in cases against secondary infections such as Covid-19 pneumonia with immunosuppression that may occur during the treatment period. In the course of Covid-19 infection, cancer and other serious comorbidities cause high rates of severe clinical picture, intensive care admission and mortality. During Covid-19 pandemic, cancer and other serious co-morbidities; It causes high rates of severe clinical picture, intensive care admission and mortality. It is recommended to evaluate patients with lung cancer individually and to plan the treatment according to their stages and performances. During the pandemic process, it should be planned to use non-invasive radiological methods instead of endobronchial interventional examinations in the diagnosis, to minimize

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The role of ferroptosis in lung cancer

Biomarker Research ◽

10.1186/s40364-021-00338-0 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Sikai Wu ◽

Chengchu Zhu ◽

Daolin Tang ◽

Q. Ping Dou ◽

Jianfei Shen ◽

...

Keyword(s):

Lung Cancer ◽

Apoptotic Cell ◽

Protein Cleavage ◽

Ischaemia Reperfusion Injury ◽

The Core ◽

Ischaemia Reperfusion ◽

The World ◽

Lung Cancer Therapy ◽

Potential Strategy

AbstractLung cancer is one of the most common cancers in the world. Although medical treatment has made impressive progress in recent years, it is still one of the leading causes of cancer-related deaths in men and women. Ferroptosis is a type of non-apoptotic cell death modality, usually characterized by iron-dependent lipid peroxidation, rather than caspase-induced protein cleavage. Excessive or lack of ferroptosis is associated with a variety of diseases, including cancer and ischaemia-reperfusion injury. Recent preclinical evidence suggests that targeting ferroptotic pathway is a potential strategy for the treatment of lung cancer. In this review, we summarize the core mechanism and regulatory network of ferroptosis in lung cancer cells, and highlight ferroptosis induction-related tumor therapies. The reviewed information may provide new insights for targeted lung cancer therapy.

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Hypoxia in Lung Cancer Management: A Translational Approach

Cancers ◽

10.3390/cancers13143421 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3421

Author(s):

Julien Ancel ◽

Jeanne-Marie Perotin ◽

Maxime Dewolf ◽

Claire Launois ◽

Pauline Mulette ◽

...

Keyword(s):

Lung Cancer ◽

Public Health Issue ◽

High Expectations ◽

Cancer Management ◽

Non Invasive ◽

Resected Nsclc ◽

Circulating Markers ◽

Experimental Approaches ◽

Translational Approach ◽

Worse Prognosis

Lung cancer represents the first cause of death by cancer worldwide and remains a challenging public health issue. Hypoxia, as a relevant biomarker, has raised high expectations for clinical practice. Here, we review clinical and pathological features related to hypoxic lung tumours. Secondly, we expound on the main current techniques to evaluate hypoxic status in NSCLC focusing on positive emission tomography. We present existing alternative experimental approaches such as the examination of circulating markers and highlight the interest in non-invasive markers. Finally, we evaluate the relevance of investigating hypoxia in lung cancer management as a companion biomarker at various lung cancer stages. Hypoxia could support the identification of patients with higher risks of NSCLC. Moreover, the presence of hypoxia in treated tumours could help clinicians predict a worse prognosis for patients with resected NSCLC and may help identify patients who would benefit potentially from adjuvant therapies. Globally, the large quantity of translational data incites experimental and clinical studies to implement the characterisation of hypoxia in clinical NSCLC management.

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