ABSTRACT
In spite of the advances in immunotherapy and targeted therapies, lung cancer continues to be the leading cause of cancer-related death. The epidermal growth factor receptor is an established target for non-small cell lung cancer (NSCLC), and its overactivation by the ligands can induce accelerated proliferation, angiogenesis, and metastasis as well as proinflammatory or immunosuppressive signals. CIMAvax-EGF is an epidermal growth factor (EGF)-depleting immunotherapy that is approved for the treatment of NSCLC patients in Cuba. The study was designed as a phase IV trial to characterize the safety and effectiveness of CIMAvax-EGF in advanced NSCLC patients treated in 119 community polyclinics and 24 hospitals. CIMAvax-EGF treatment consisted of four bi-weekly doses followed by monthly boosters. Overall, 741 NSCLC patients ineligible for further cancer-specific treatment were enrolled. CIMAvax-EGF was safe, and the most common adverse events consisted of mild-to-moderate injection site reactions, fever, chills, tremors, and headache. For patients completing the loading doses, the median survival was 9.9 months. For individuals achieving at least stable disease to the frontline and completing vaccination induction, the median survival was 12 months. Most of the functional activities and symptoms evaluated through the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire improved over time. In conclusion, this real-world trial demonstrated that CIMAvax-EGF was safe and effective in patients who were vaccinated in the maintenance scenario. A larger effect was seen in subjects with poor prognosis like those with squamous tumors and high EGF levels. Remarkably, this community-based intervention was very important because it demonstrated the feasibility of treating advanced lung cancer patients with active immunotherapy in primary care institutions. In addition to CIMAvax-EGF, patients received supportive care at the community clinic. Vaccine administration by the family doctors at the polyclinics reduced the patients' burden on the medical oncology services that continued providing chemotherapy and other complex therapies. We conclude that community polyclinics constitute the optimal scenario for administering those cancer vaccines that are safe and require prolonged maintenance in patients with advanced cancer, despite the continuous deterioration of their general condition. Clinical trial registration: https://rpcec.sld.cu/trials/RPCEC00000205-En, identifier RPCEC00000205.
ABSTRACT
Fundamento: el adenocarcinoma es el tipo de cáncer más frecuente de pulmón en las mujeres y entre las personas que no fuman crece con mayor lentitud, pero tiende a metastizar antes y de manera más amplia. Sólo alcanza la curación una minoría de los pacientes.Objetivo: presentar el caso de un paciente portador de adenocarcinoma de células no pequeñas de localización pulmonar.Caso Clínico: paciente de 58 años de edad, masculino, fumador en el que las manifestaciones paraneoplásicas precedieron a las propias del tumor por más de siete meses de evolución.Conclusiones: por la poca curabilidad del cáncer de pulmón es que se presenta este caso con evolución favorable y supervivencia de más de dos años y medio tras la cirugía y tratamiento oncoespecífico(AU)
Background: adenocarcinoma is the most frequently type of lung cancer in women and is non-smoker people. Adenocarcinoma developes slower, but tends to metastasize sooner and spreads widely. Only a few number of patients reachs cure.Objective: to present a clinical case of adenocarcinoma carries with big pulmonary cells.Case clinical: a 58 years old male smoker patient is presented, paraneoplasics manifestations preceded that of the tumor properly, during more than seven months of valuation.Conclusions: this case is presented don account of few curability refered in lung cancer, with favorable evolution and more than 2, 5 years of survivance after surgery, oncologic treatment and immunotherapy. A review of concerned literature in relation with clinical aspects, diagnosis and therapeutics about this tumor, lees frequently in male was presented(AU)
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Non-Small-Cell Lung/epidemiology , Lung Neoplasms/epidemiologyABSTRACT
Fundamento: el adenocarcinoma es el tipo de cáncer más frecuente de pulmón en las mujeres y entre las personas que no fuman crece con mayor lentitud, pero tiende a metastizar antes y de manera más amplia. Sólo alcanza la curación una minoría de los pacientes. Objetivo: presentar el caso de un paciente portador de adenocarcinoma de células no pequeñas de localización pulmonar. Caso Clínico: paciente de 58 años de edad, masculino, fumador en el que las manifestaciones paraneoplásicas precedieron a las propias del tumor por más de siete meses de evolución. Conclusiones: por la poca curabilidad del cáncer de pulmón es que se presenta este caso con evolución favorable y supervivencia de más de dos años y medio tras la cirugía y tratamiento oncoespecífico.
Background: adenocarcinoma is the most frequently type of lung cancer in women and is non-smoker people. Adenocarcinoma developes slower, but tends to metastasize sooner and spreads widely. Only a few number of patients reachs cure. Objective: to present a clinical case of adenocarcinoma carries with big pulmonary cells. Case clinical: a 58 years old male smoker patient is presented, paraneoplasics manifestations preceded that of the tumor properly, during more than seven months of valuation. Conclusions: this case is presented don account of few curability refered in lung cancer, with favorable evolution and more than 2, 5 years of survivance after surgery, oncologic treatment and immunotherapy. A review of concerned literature in relation with clinical aspects, diagnosis and therapeutics about this tumor, lees frequently in male was presented.
