Immunotherapy in first-line treatment of recurrent non-small cell lung cancer

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.

Keywords

• immunotherapy
• pembrolizumab
• non-small-cell lung cancer
• autoimmune hypothyroidism