Inmunoterapia en cáncer de pulmón metastásico: Experiencia del Hospital Italiano de Buenos Aires

Jésica Storino; Matías Cerini; Lorena Lupinacci; Sergio Specterman; Federico Cayol

doi:10.56969/oc.v25i1.24

Autores/as

Jésica Storino Sección Oncología, Hospital Italiano de Buenos Aires
Matías Cerini Sección de Oncología, Hospital Italiano de Buenos Aires
Lorena Lupinacci Sección Oncología, Hospital Italiano de Buenos Aires
Sergio Specterman Sección Oncología, Hospital Italiano de Buenos Aires https://orcid.org/0000-0002-5701-2171
Federico Cayol Sección de Oncología Clínica, Hospital Italiano de Buenos Aires https://orcid.org/0000-0001-9794-2173

DOI:

https://doi.org/10.56969/oc.v25i1.24

Palabras clave:

cáncer de pulmón metastásico, inmunoterapia, inhibidores de los puntos de control PD-1 y PD-L1, información del mundo real, metastatic lung cancer, immunotherapy, checkpoint inhibitors PD-1 and PD-L1, real world information

Resumen

El cáncer de pulmón es la principal causa de muerte por cáncer en el mundo1. Más del 80% de los casos corresponden al subgrupo de carcinomas de pulmón de células no pequeñas (CPCNP)2. A pesar de que en los últimos años han aumentado las opciones terapéuticas para los subgrupos molecularmente seleccionados (ej.: mutación del factor de crecimiento epidérmico (EGFR), re arreglos de la quinasa del linfoma anaplásico (ALK), mutación ROS1, entre otros), estos tratamientos son inefectivos en aquellos sin estas alteraciones moleculares. Por lo que en estos pacientes la única opción posible era la quimioterapia, con una supervivencia global mediana menor de 18 meses en los ensayos clínicos3-5.

Recientemente, la inmunoterapia ha aparecido como una opción estándar de tratamiento, generando mejoría en la supervivencia global y calidad de vida6-12.

Los inhibidores de los puntos de control inmunitarios aprobados por la Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT) para el tratamiento del CPCNP son contra el PD-1 (pembrolizumab y nivolumab) y el PD-L1 (atezolizumab y durvalumab).

Habitualmente, los factores que se utilizan para la elección del tratamiento en estos pacientes son la ausencia de mutaciones drivers, los tratamientos previos recibidos, los niveles de expresión de PD-L1, la extensión de enfermedad, la histología y el performance status, entre otros2.

A propósito de esto se revisó una serie de pacientes con diagnóstico de cáncer de pulmón metastásico tratados con inmunoterapia en el Hospital Italiano de Buenos Aires durante el período 2013-2019.

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