Immunotherapy, also known as biological therapy, can bring invaluable benefits to people struggling with certain types of lung cancer.

This method of treatment is based on the use of highly selective drugs that stimulate the immune system to effectively fight cancer.

For a couple of decades, immunotherapy has been able to change the views on the treatment of many cancers, including lung cancer, breast cancer, colorectal cancer.

In this article we will look at how immunotherapy works, how biological drugs help people with lung cancer and what side effects can there be.

What is lung cancer immunotherapy?.

Immunotherapy is a relatively new option for cancer treatment. It complements standard therapy methods, helping immunity to recognize and attack cancer cells. This is achieved by "learning" lymphocytes or influencing certain controlling genes in the immune system.

There are several types of immunotherapy for fighting lung tumors:.

• adaptive T-cell immunotherapy.

• inhibitors of immune control points.

• therapeutic vaccines Each type of immunotherapy has its own advantages, disadvantages and application features. There is still a need for additional research, because medicine is just beginning to open this direction and manage the amazing possibilities of the immune cell.

How Immunotherapy Works.

All types of immunotherapy work in different ways. Let's figure it out..

Adaptive T-Cell Immunotherapy.

Adaptive T-cell immunotherapy is based on the extraction of T-lymphocytes from the patient's body with subsequent reprogramming and introduction back into the blood. In the laboratory, cells are "trained" to attack a tumor.

The method is rather complicated and expensive. Adaptive T-cell therapy requires modern laboratory equipment and specially trained specialists, so it is not available in all cancer centers.

This method demonstrates promising results, but it needs additional studies to be widely used for the treatment of lung cancer.

Inhibitors of immune control points.

The human immune system constantly examines the body for the presence of foreign particles and mutated cells, immediately recognizing and eliminating them. Immune cells carry certain control molecules that interfere with the immune system to damage normal tissues. However, cancer cells use the same control points to avoid attack from the immune system.

Inhibitors of immune control points do not allow malignant cells to be covered by these molecules. By suppressing control points, these drugs help the lymphocytes to target the tumor and destroy it.

The US Food and Drug Administration (FDA) has approved several inhibitors of immune control points for the treatment of lung cancer.

These drugs are divided into two categories:.

PD1 and PD-L1 Inhibitors.

Block the ability of malignant cells to use control points on T-lymphocytes. They patrol the body in search of a potential threat. By suppressing PD1 and PD-L1, we actually "untie the hands" of the immune system, allowing T cells to target and attack the cancer.

Examples of inhibitors PD1 and PD-L1 (international non-patented names):.

• nivolumab (nivolumab).

• durvalumab (durvalumab).

• atezolizumab (atezolizumab).

• pembrolizumab (pembrozulimab).

• avelumab (avelumab) 2. CTLA-4 Inhibitors.

These drugs are slightly different from the previous group. Inhibitors of CTLA-4 cause T-lymphocytes to actively search for and destroy cancer cells. Currently there are not many options available for CTLA-4. In fact, only one drug, ipilimumab (ipilimumab) was approved, which is successfully used in the treatment of melanoma.

Therapeutic vaccines.

Therapeutic vaccines teach the immune system to react to protein-antigen specific for malignant cells. Vaccines for the treatment of lung cancer are targeted against MAGE-3 and NY-SEO-1 antigens, but currently scientists are testing vaccines against other tumor antigens.

Who needs immunotherapy?.

Typical candidates for immunotherapy are patients with certain subtypes of non-small cell lung cancer (NSCLC). Often immunotherapy is recommended for patients whose cancer returned after previous treatment. Sometimes immunopreparations are the first and main therapeutic option, usually in combination with chemotherapeutic agents.

Unfortunately, doctors are not yet able to use the full potential of immunotherapy. More research is needed to determine why some patients respond very well, while others do not respond at all. In this research, knowledge about the cellular receptors of cancer.

Advantages, risks and side effects.

People who respond well to immunotherapy experience fewer side effects than standard chemotherapy with cytostatics. If the response to immunotherapy is good, it can stop the development of the disease, prevent the formation of metastases and significantly prolong the life of patients even in advanced stages of lung cancer.

Among the most frequent and easy side effects: joint pain, fatigue, decreased appetite, cough, diarrhea and constipation, nausea, skin rash and itching.

Unfortunately, some patients on immunopreparations risk excessive activation of their immune system. In these rare cases, lymphocytes begin to attack healthy tissue and internal organs, an autoimmune process develops.

Then the treatment has to be stopped so as not to cause the sick body even more harm. Patients remain to rely on alternative methods of treating lung cancer - surgical removal of the tumor, chemotherapy, radiation.

Research and the future of immunotherapy.

Foreign scientists are optimistic about immunotherapy and its future in the treatment of lung cancer, but recognize a sufficient number of gaps in modern knowledge. The number of completed clinical trials of immunopreparations and vaccines is small, but pharmaceutical companies are actively working in this direction.

The available results show that immunopreparations can give huge opportunities in the treatment of lung cancer and other cancers.

The main focus of science is on "personalized medicine," that is, on the search for criteria for selecting immunotherapy for the treatment of a particular patient. It is known that immunopreparations do not work for everyone, and doctors need to know why this happens.

Introducing new laboratory tests, one could predict the response to immunotherapy and more accurately predict the development of the disease.

medbe. en.