Current Algorithm for Treatment of Advanced NSCLC Patients: How to Include Active Immunotherapy?

Gisela Gonzalez, Arlhee Diaz-Miqueli, Tania Crombet, Luis E. Raez, Agustin Lage

Center of Molecular Immunology, Havana, Cuba.
Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, USA.

DOI: 10.4236/jct.2013.48A010                

Abstract

Despite the availability of different treatments for advanced NSCLC, all of them have a palliative intention and a cure for the disease is unlikely. Thus, advanced lung cancer remains as an unmet medical need. Chemotherapy has been used as the therapy of choice for advanced NSCLC patients, but it is mainly limited by the patient’s performance status. More recently, targeted therapies have introduced more specific treatment options that show efficacy in specific niche of patients, but precisely due to their target specificity, they usually provoke early resistance. In addition to these limitations, most of the best drugs currently used for treatment of advanced NSCLC show small increases in patient survival with severe associated toxicity. Novel drugs with low toxicity that could be given chronically to control the advanced disease can make a difference. They could allow the management of advanced cancer as a chronic disease that, even when not cured, it can be controlled for long periods of time offering patients a good quality of life. Active-specific immunotherapy is an area of oncology that is rapidly expanding with encouraging results. Cancer vaccines against many potential targets have shown to increase patient survival in clinical trials at all stages NSCLC, when included as first-line, maintenance, or second-line therapy. Safety of cancer vaccines supposes a new hope for cancer therapy, and this unique characteristic makes it possible to be used in sub-sets of patients that cannot receive other approved treatments because of their high toxicity. In this paper, authors propose how active immunotherapy could be included in the current algorithm for treatment of advanced NSCLC patients.

Keywords

Lung Cancer Therapy; Active Immunotherapy; Cancer Vaccines

Conflicts of Interest

The authors declare no conflicts of interest.

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