Publication: Caracterización del microambiente tumoral y puntos de control inmune del carcinoma microcítico de pulmón : implicaciones pronósticas y predictivas
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2022-04-19
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Universidad Complutense de Madrid
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Abstract
El carcinoma microcítico de pulmón (CMP) es una de las neoplasias más agresivas y de peor pronóstico conocidas, para la que disponemos de un escaso arsenal terapéutico. A pesar del esfuerzo en las últimas décadas para intentar diseñar terapias frente a diversas dianas moleculares, el beneficio obtenido ha sido modesto, sobre todo si lo comparamos con el éxito obtenido en el carcinoma no microcítico de pulmón. La reciente caracterización transcripcional del CMP y sus implicaciones en la biología de la enfermedad podrían facilitar un tratamiento más individualizado en el futuro. En los últimos años el tratamiento en combinación de quimioterapia con inhibidores de PD-L1 ha demostrado un beneficio en la primera línea de tratamiento para pacientes con CMP-EE (enfermedad extendida), aunque con un moderado impacto en supervivencia. Actualmente no disponemos de biomarcadores predictivos robustos que nos permitan anticipar qué pacientes se beneficiarán de tal estrategia terapéutica. Asimismo, es de interés prioritario el reconocer dianas terapéuticas inmunológicas adicionales en esta enfermedad, y desarrollar las estrategias terapéuticas oportunas...
Small-cell lung cancer (SCLC) is one of the most aggressive malignancies worldwide, having limited treatment options and poor prognosis. Despite the efforts in order to understand the biology of the disease and to design new molecular targeted treatments, no obvious benefit has been observed in this disease as compared to the advances achieved in non-small cell lung carcinoma over the last two decades. Up-front chemotherapy plus immunotherapy combinations have most recently proven a modest but significant survival improvement in patients with extensive stage disease. We are at present however unable to predict which patients are benefitting from adding PD-L1 inhibitors to standard chemotherapy. With these premises there are two obvious unmet clinical needs in this context. First, to identify reliable predictive biomarker of benefit for PD-1/PD-L1 based treatments. Second, to uncover biologically relevant additional immune targets that may be therapeutically exploitable in patients unlikely to benefit from currently available immunotherapy options...
Small-cell lung cancer (SCLC) is one of the most aggressive malignancies worldwide, having limited treatment options and poor prognosis. Despite the efforts in order to understand the biology of the disease and to design new molecular targeted treatments, no obvious benefit has been observed in this disease as compared to the advances achieved in non-small cell lung carcinoma over the last two decades. Up-front chemotherapy plus immunotherapy combinations have most recently proven a modest but significant survival improvement in patients with extensive stage disease. We are at present however unable to predict which patients are benefitting from adding PD-L1 inhibitors to standard chemotherapy. With these premises there are two obvious unmet clinical needs in this context. First, to identify reliable predictive biomarker of benefit for PD-1/PD-L1 based treatments. Second, to uncover biologically relevant additional immune targets that may be therapeutically exploitable in patients unlikely to benefit from currently available immunotherapy options...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 03-12-2021