RESUMO
The introduction of immunotherapy has brought about a paradigm shift in the management of advanced non-small cell lung cancer (NSCLC). It has not only significantly improved the prognosis of patients but has also become a cornerstone of treatment, particularly in those without oncogenic driver mutations. Immune checkpoint inhibitors (ICIs) play a crucial role in the treatment of lung cancer and can be classified into two main groups: Anti-cytotoxic T lymphocyte antigen-4 (Anti-CTLA-4) and anti-T-cell receptor programmed cell death-1 or its ligand (Anti-PD-1 and Anti-PD-L1). Certainly, the landscape of approved first line immunotherapeutic approaches has expanded to encompass monotherapy, immunotherapy-exclusive protocols, and combinations with chemotherapy. The complexity of decision-making in this realm arises due to the absence of direct prospective comparisons. However, a thorough analysis of the long-term efficacy and safety data derived from pivotal clinical trials can offer valuable insights into optimizing treatment for different patient subsets. Moreover, ongoing research is investigating emerging biomarkers and innovative therapeutic strategies that could potentially refine the current treatment approach even further. In this comprehensive review, our aim is to highlight the latest advances in immunotherapy for advanced NSCLC, including the mechanisms of action, efficacy, safety profiles, and clinical significance of ICI.
RESUMO
Omics technologies have revolutionised fundamental and medical research. Oncology is perhaps the field where these technologies have been most rapidly adopted and where they have had their biggest impact, dramatically transforming clinical practice guidelines over a very short period of time. Along with this transformation has come an even larger array of technologies, tools and jargon, that make following the most recent developments in the field a truly daunting task for those not involved in it. This chapter is intended to provide a general overview of evolving topics in oncology research in the era of big data analysis and precision medicine, with a specific focus on the use of tumour biomarkers, tumour biomarker tests, targeted drugs and the changing landscape of clinical trial designs.
Assuntos
Oncologia , Neoplasias , Biomarcadores Tumorais , Ensaios Clínicos como Assunto , Humanos , Oncologia/tendências , Medicina de Precisão/tendênciasRESUMO
Os biomarcadores tumorais dosados no líquido pleural possuem relevância estatística e clínica para serem utilizados como sugestão do diagnóstico diferencial entre derrames pleurais malignos e benignos nos casos onde os primeiros resultados da citopatologia e histopatologia são ambos inconclusivos AU
Tumor biomarkers measured in pleural fluid have statistical and clinical relevance for use as a suggestion of differential diagnosis between benign and malignant pleural effusions in cases where the first results of cytopathology and histopathology are both inconclusive AU.