Immune Checkpoint Inhibitors in the Treatment of Non-Small Cell Lung Cancer

Year 2020, , 63 - 68, 08.04.2020

Ümmügül Üyetürk , Ayhan Çetinkaya

https://doi.org/10.5505/abantmedj.2020.46873

Abstract

Lung cancer is the most common and deadliest cancer in the world. Non-small cell lung cancer (NSCLC), which is mostly diagnosed in advanced stages, has a short overall survival despite standard chemotherapy and targeted therapies. Therefore, the quest to find new treatment continues. When programmed death-1 (PD-1) receptors expressed from activated T lymphocytes bind with PD-ligand 1 (L1) and PD-L2 expressed by tumor cells, T lymphocyte activation is downregulated and tumor cells protect themselves and survive. In NSCLC, immune check point inhibitors nivolumab and pembrolizumab act by inhibiting PD-1 receptors, while atezolizumab and durvalumab by inhibiting PD-L1 receptors. The aim of this review is to evaluate which NSCLC cell groups and which stage these treatments will be most effective and also the side effect profile.

Keywords

Non-small cell lung cancer, immune check-point inhibitors, nivolumab, pembrolizumab, atezolizumab, durvalumab

Küçük Hücreli Dışı Akciğer Kanseri Tedavisinde İmmun Kontrol Nokta İnhibitörleri

Abstract

Akciğer kanseri, tüm dünyada en fazla görülen ve en fazla ölüme neden olan kanserdir. Çoğunlukla ileri evrede tanı konulan küçük hücreli dışı akciğer kanserinde (KHDAK) standart kemoterapilere ve hedefe yönelik tedavilere rağmen sağkalım süresi oldukça kısadır. Bu yüzden yeni tedavi arayışları devam etmektedir. Aktive T lenfositlerden ekspresse edilen programlanmış ölüm-1 (PD-1) reseptörleri tümör hücreleri tarafından ekspresse edilen PD-ligand 1 (L1) ve PD-L2 ile bağlandığında T lenfosit aktivasyonu downregüle edilerek tümör hücreleri kendilerini korumakta ve yaşamaya devam etmektedirler. KHDAK’de immun kontrol nokta inhibitörlerinden nivolumab ve pembrolizumab PD-1 reseptörlerini, atezolizumab ve durvalumab ise PD-L1 reseptörlerini inhibe ederek etki gösterir. Bu derlemenin amacı bu tedavilerin hangi KHDAK hücre grubunda, hangi evrede kullanılmasının en fazla yarar sağlayacağını ve yan etki profilini değerlendirmektir.

Keywords

Küçük hücreli dışı akciğer kanseri, immun kontrol nokta inhibitörleri, nivolumab, pembrolizumab, atezolizumab, durvalumab

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