Learning objectives
The objectives of this work are:
Brief overview of new oncology drugs in lung cancer: targeted drugs and immunotherapy
Key points of response patterns according iRECIST
Examples and discussion of events related to new oncologic treatments,
including clinical and imaging findings
Imaging findings:
Treatment response patterns according iRECIST - partial response,
complete response,
stable disease,
unconfirmed progression and confirmed progression
Targeted-related adverse events
Immune-related adverse events
Background
Recent advances in understanding the molecular mechanisms of cancer have opened a new era of precision medicine for cancer treatment,
especially in lung cancer.
Precision cancer therapies target specific molecules that are responsible for cancer development and progression,
and they achieve marked treatment benefits in specific cohorts of patients.
However,
these therapies are also associated with a different response criteria and variety of complications that are often unique to specific groups of anticancer agents.
Findings and procedure details
Precision therapy includes in lung cancer:targeted therapy and immunotherapy.Fig. 1
This therapy is different from conventional chemotherapy:
Traditional cytotoxic chemotherapies:destroy rapidly growing cells,
and act on the mechanism of cell division
Targeted drugs:are intended to interfere with specific aberrant molecular mechanisms involved in the development of tumors,
for example,
associated with tumor antiangiogenesis
Immunotherapy:uses immune system responses to treat cancer
Targeted drugs
The advantage of target drugs is to act more accurately and with fewer side effects
In general,
these drugs are classified into:
Monoclonal...
Conclusion
Advancements in precision cancer therapies challenge the current imaging.
To contribute to the current care of patients with cancer,
radiologists must be keep abreast of the major advancements in treatment of cancer and knowledgeable about the atypical tumor response pattern and common adverse events seen with this novel class of drugs.
Personal information
Dr.
Pedro Naime Barroso de Araujo
MD.
Radiology
São Paulo,
Brazil
Email:
[email protected]
References
Facchinetti F,
Tiseo M,
Maio MD,
et al.
Tackling ALK in non-small cell lung cancer: the role of novel inhibitors.
Transl Lung Cancer Res.
2016; 5(3):301–321.
Alexander D Le,
Saeed K Alzghari,
Gary w Jean,
Ninh M La-Beck.
Update on targeted therapies for advanced non-small cell lung cancer: nivolumab in context.
Therapeutics and Clinical Risk Management 2017:13 223–236.
Middleton MR,
Dalle S,
Claveau J,
et al.
Real-world treatment practice in patients with advanced melanoma in the era before ipilimumab: results from the IMAGE study.
Cancer...