Big change for lung cancer

Noemi Rigwart, MD, oncologist at Clinique de Barcelona.

Lung cancer is one of the most common tumors in Spain. Over the years, his treatment options have improved, and thus the life expectancy of patients who suffer from it. Naomi Rigwartspecialist in oncology at the Hospital Clinique de Barcelona, ​​analyzes in an interview with medical writing How treatments for this disease have improved, as well as the ability of immunotherapy to increase a patient’s quality of life, and the importance of achieving genomic identification and new treatment options.

Watch here the full interview with oncologist Noemí Reguart.

How have lung cancer treatments evolved?

The Lung cancer treatmentDuring the past ten fifteen years, he has suffered from Quantum leap very important. Looking back, 20 years ago we treated all patients the same way: We treated them with chemotherapy. What has happened during these years is that thanks to all the advances in identifying molecular targets, we have been able to select those who benefit most from specific targeted therapies. This is called precision medicineGiving the best treatment to each patient individually according to the genetic characteristics of the tumor.

The second most important advance is the development that has occurred in the field of Immunotherapy. It is a strategy that means a paradigm shift in treatment, not only for lung cancer, but also for other solid tumors, since it has a very different approach.

What we do is stimulate the immune system so that it recognizes the tumor and attacks it and destroys it. Thus, immunotherapy can be used as a strategy or also in chemotherapy combination. There are targeted therapies and options with immunotherapy, and of course we maintain chemotherapy as a strategic basis for lung cancer treatment.

How do we say that immunotherapy improved the patient’s life?

An oncologist discusses how new treatments can improve the quality of life for cancer.

very much. First, because the toxicity characteristics of immunotherapy are very different from those of chemotherapy. It is a more favorable profile, does not produce many adverse effects and helps to improve the patient’s quality of life. This entails a difference from what happened with chemotherapy. With this, you had to do short treatments, for a very specific period of time, to prevent the buildup of side effects. With immunotherapy, we can carry out prolonged treatments of two years or more with a very good quality of life. This allows the presence of a file Efficacy in preserving the tumor.

Also, there is efficiency. What we’ve achieved with immunotherapy, as opposed to chemotherapy, is getting patients who can undergo long periods of treatment for years with good control of disease caused by their immune system. If you translate it to quality of lifeAll the advantages. Several studies have shown that immunotherapy improves quality of life more than chemotherapy. This allows the disease’s growth to be controlled for a longer period and Toxicity profile It is lower.

In other words, we can say that life expectancy has improved significantly.

Yes, immunotherapy is set as a standard for affected patients metastatic lung cancer And it improved not only the quality of life, but also the survival outcome compared to chemotherapy. Today, patients with advanced disease are treated with immunotherapy, unless they have specific contraindications. In addition, the benefit of immunotherapy has translated into other disease states. Until now it has been focused on patients with systemic disease, when it can no longer be surgically removed. In recent months, we have obtained positive results showing that immunotherapy is also beneficial for patients who have undergone surgery or who have undergone surgery with the aim of reducing the risk of disease recurrence. In other words, nearly all lung cancer patients at any stage of the disease benefit from treatment with immunotherapy.

A doctor details the benefits of immunotherapy for patients with lung cancer.

How has the COVID-19 pandemic affected these patients?

At first it was tragic, because we had a lot of restrictions on visitors in the hospital. We thought it would be difficult for us to be able to provide the follow-up that these patients need, but telemedicine It has come a long way. Day hospital treatments were not affected at all. The quality of care provided to lung cancer patients was also not affected by Corona virus disease.

Yes, it is true that the disease afflicted our patients, too. We’ve had patients with cancer, not just in the lung, but other tumors who have had the virus, but, as with the non-cancer people, many of them have been treated pretty well. Moreover , vaccination Both the prevalence and severity of cases have changed and the situation is now very controlled.

Were there many late diagnoses?

Initially, there was an effect on delay and identification of patients. observed in derivation, and many of them are from the primary health care system, where the patient is recognized normally. People went to the doctor less, and there were fewer checkups, which is why there was little delay. But this only happened during the first year. Once he passed, the numbers began to rise again and the usual numbers were recovered. Now we are in an incident equal to the usual.

In your opinion, what needs should be covered in this cancer?

One of the main needs that we have now, not only in lung cancer, but in all tumors, is genome identification. We must make facilities available to all patients with oncology so that they can perform genetic analysis. It is very important because current medicine in oncology is based on precision medicine. We have more and more targeted therapies; We define subgroups of patients who have highly distinct tumors based on genetic alterations.

In order to perform these genetic analyzes, an adequate infrastructure of hospitals is required. This, unfortunately, is not yet available in all healthcare centers in Spain. I would say one of the most important needs we have is to modernize or be able to have all of these technologies in health hospitals to respond not just to cancer, but to all diseases in general.

“In order to perform genetic analyzes, adequate infrastructure for hospitals is required”

I would like to ask you about Libtayo (simelipimab)It is a new therapeutic alternative for this tumor. Who is this treatment recommended for?

It is recommended for advanced lung cancer patients, that they have expression of PD-L1, and that this is a biomarker, what we call precision medicine. Patients who have a specific biomarker in their tumor, with an amount or concentration of the biomarker greater than 50 percent, are advised to be treated with this new type of immunotherapy called cemiplimab.

How does this new treatment improve patients’ quality of life?

The treatment improves the quality of life by itself compared to chemotherapy, as is the case with other immunotherapy agents. But the quality of life also improves because this drug allows it Reduced risk of death by 43%, and increase the number and duration of answers. It also improves the toxicity profile. It is more convenient and more beneficial than chemotherapy. The group assumes a better tumor response.

What are the data shown in the experiments?

As mentioned before, simelipimab It has been shown to reduce the risk of death by 43% compared to chemotherapy, and is more effective in this specific subgroup of patients with PD-L1 expression greater than 50%. And also Reduces the risk of progression of tumor in 46 percent. This is very good because it increases response times, or delays when the tumor will progress or grow.

What can we say that this new treatment means for lung cancer patients?

It is a new therapeutic alternative for our patients. Although we have other treatments with immunotherapy, having more treatment options allows us to customize treatments more. Currently there Various types of immunotherapy are under development, but one of the most important things is knowing what to do with them when immunotherapy stops working. Several new combination agents are being investigated with different types of immunotherapy to restore responses to these agents with immunotherapy. In addition, allowing these patients to be able to spend more time on the benefit of immunotherapy treatment.

Would this treatment be beneficial if applied to other tumors?

Yes, in fact, treatment with cemiplimab is an anti-PD1 treatment, an agent that is treated with immunotherapy like other immunomodulating agents. Immunotherapy treatment Today it is applied to many tumorsFor example, head and neck cancer, breast cancer, colorectal cancer … Immunotherapy therapy is being explored and is already prescribed in many types of solid tumors.

Cooperation with Sanofi

Reguart analyzes new therapeutic possibilities that improve patients’ quality of life.

Although it may contain statements, statements, or notes from health institutions or professionals, the information in medical writing is edited and prepared by journalists. We recommend the reader to consult a health professional with any health-related questions.

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