Title : Vaccines and monoclonal antibodies in the prolonged treatment of non-small cell lung cancer: 20 years of follow-up
Abstract:
Lung cancer is the first cause of death from cancer in the world and in some countries as the first cause of death for both sexes. Early diagnosis and timely therapy is successful for increasing the survival of these patients, however, the masking with frequent symptoms of other diseases makes it be diagnosed in advanced stages of the disease. It is reported that a group of patients have the probability of being long-term survivors, confirming that with some therapies directed at specific targets, survival increases. For patients with non-small cell lung cancer, survival to the first line of chemotherapy has been extended with some recent immune checkpoint inhibitor therapies up to 24-26 months, but this is not the most frequent. Even this type of therapy is not accessible to all patients at this stage of the disease.
For 20 years, the Center for Molecular Immunology has been conducting clinical trials with products generated at the institution, aimed at tumor antigen therapeutic targets associated with advanced non-small cell lung cancer (NSCLC). After analyzing more than 3,900 patients in a database integrated with all the clinical trials conducted in the period from 2002 to 2020 with the Cimavax EGF and Vaxira vaccines and the humanized monoclonal antibody nimotuzumab, it was found that around 20% of the patients had a long survival, greater than 24 months, when they were treated with immunotherapies; but also that a group of patients who were controls in these studies were long survivors.
Seeking to identify the correlation between some significant parameters in patients treated taking into account recipients, immunological inflammation, disease stage, histological type, among others, with long survival, they were analyzed through a covariate classification tree, locating as main variable survival.
Both in the control groups and in those treated with Cuban biotechnology products, it was identified that there is a bimodality in the analyzed populations and that around 7% of the patients have the probability of being long-term survivors. Depending on the product analyzed, predictive parameters of a good response to these treatments were identified, leading to the creation of a therapeutic algorithm to select the appropriate therapy. These parameters are related to the inflammatory level such as the NLR, the PLR and the histological type of the disease.
