Due to the poor awareness of cancer screening in Chinese people, the early symptoms of lung cancer are not obvious. Many patients often have advanced lung cancer when they have chest tightness, chest pain or persistent cough. Half of lung adenocarcinoma patients have positive expression of EGFR (epidermal growth factor receptor) gene, and the disease can be controlled by targeted drugs. However, EGFR-negative patients have not been properly treated in the past, and the treatment is in a bottleneck period.
With the development of tumor immunology and the improvement of biotechnology, tumor immunotherapy has been widely concerned, and breakthroughs have been made in clinical research such as melanoma and kidney cancer. People have also explored immunotherapy for lung cancer, but for many years, scholars believe that lung cancer is a malignant tumor with weak immunogenicity, and the efficacy of immunotherapy for lung cancer is still controversial, which is regarded as the frontier field of lung cancer research.
Birth of immunotherapy for lung cancer
In recent years, lung cancer-related antigens such as MAGE-A3 and mucin (Mu cin- 1), programmed death protein-1(PD- 1) and its ligand PD-L 1, as well as cytotoxic T lymphocyte-associated antigen -4(CTLA-4) and other T.
20 13 World Lung Cancer Congress (WCLC) and 20 14 European Lung Cancer Congress (ELCC) both proposed that "immunotherapy will open a new era of lung cancer treatment". Exciting research results have been made in the field of immunotherapy for lung cancer, which has brought more and more opportunities and more and more arduous challenges to the study of transformation.
In 20 15, some tumor organizations held the first international conference on tumor immunotherapy.
From September 2065438 to September 2006, immunotherapy was applied to the treatment of lung cancer. This therapy can inhibit the abnormal combination of PD-L 1 to cancer cells and PD- 1 to immune cells by awakening autoimmune cells, and the effect is quite good. About 40% patients who received immunotherapy alone were under control. Nearly 60% patients with immunotherapy combined with chemotherapy got better.
20 16, 165438 10, an important study was published at the European medical oncology conference held in Copenhagen, Denmark. It was found that patients with lung cancer survived longer than those who received chemotherapy after taking Keytruda as the first choice drug. Keytruda is the first drug approved to block a cell pathway called PD- 1, which restricts the immune system from attacking melanoma cells.
20 18 10 1, the tumor immunotherapy, which has been popular for many years, finally won the 20 18 Nobel Prize in Physiology or Medicine! The winners are American scientist James P. Allison and Japanese scientist Tasuku Honjo (Tasuku Honjo).
Prior to this, people's views on cancer immunotherapy were always mixed, but this time, the pioneering contribution of researchers in immunotherapy has completely changed the pattern of human fight against cancer.
100 For more than a decade, scientists have been trying to involve the immune system in fighting cancer. There was only limited clinical research and development before the breakthrough discovery of the two winners. Checkpoint therapy has now completely changed the treatment of cancer and fundamentally changed our view on cancer treatment.
-Nobel Prize official website.
In fact, cancer immunotherapy has been good news in recent years. At present, it shows strong anti-tumor activity in the treatment of many tumors, such as melanoma, non-small cell lung cancer, renal cancer, prostate cancer and so on. Many cancer immunotherapy drugs have been approved by FDA for clinical treatment.
Among them, the most familiar patient may be 90-year-old former US President Jimmy Carter (it was during this presidency that China and the United States formally established diplomatic relations). In 20 15 years, he unfortunately suffered from brain metastasis of malignant melanoma. Fortunately, President Carter was miraculously "clinically cured" after receiving comprehensive treatment including immunotherapy.
Real case of immunotherapy for lung cancer
At the age of 56, Mr. Zhang was diagnosed with lung cancer and tried various treatments including chemotherapy. When chemotherapy no longer worked, Mr. Zhang felt extremely sad and desperate. Forced, he can only treat a dead horse as a living horse doctor. He decided to try immunotherapy recommended by Japanese hospitals.
2065438+May 2006, Mr. Zhang found the health of Duomu through online consultation. When Duomu Health first came into contact with Mr. Zhang, he was not completely sure about the treatment of Mr. Zhang's illness.
However, at the strong request of Mr. Zhang, Duomu Health won the last straw for Mr. Zhang and immediately contacted the Japanese immunotherapy hospital to submit information and apply for immunotherapy.
Fortunately, Mr. Zhang successfully passed the case review in Japanese hospitals and officially received immunotherapy on June 20th, 16.
After a course of treatment, Mr. Zhang's chest pain was obviously relieved, shortness of breath disappeared, hemoptysis stopped, and tumor markers decreased by more than half. Recalling the experience that the tumor was not small but grew bigger and bigger during chemotherapy, Mr. Zhang said that he could feel that the tumor focus was indeed shrinking.
After 4 months of treatment, CT showed that the tumor was obviously reduced, the pleural effusion was obviously reduced, the right lung that was completely blocked before treatment was partially opened, and the tumor on the liver was also reduced.
In order to consolidate the curative effect, the second course of immunotherapy was carried out at the beginning of 17, and the progress was very smooth. Mr. Zhang is in good health at present. He has been keeping in touch with the attending doctor since he came back from the Japanese hospital, and has been recuperating according to the doctor's advice, doing regular ct examinations, and always paying attention to the development trend of his illness.
Teacher Zhang said with emotion: The survival rate of general lung cancer after five years is about 17%. For patients whose cancer cells have metastasized and spread, the figure is less than 5%, and they can still be with their families now. This is the blessing of God and the credit of immunotherapy.
How does immunotherapy work?
Immune cells usually need two important steps to clear cancer cells. The first step is identification, and the second step is exclusion.
The first is recognition. Immune cells need to identify some surface features of tumor cells and find that they are bad people. It's like a patrolman judging whether people on the street are gangsters from comprehensive appearance information such as hair style, clothes and tattoos.
Then it was eliminated. It is useless for the police to know that a person is a triad, but they must be able to eradicate it. Similarly, immune cells can not only find cancer cells, but also need to remove them.
The occurrence of cancer shows that the regulatory function of immune cells has failed, which is called "immune escape". There is a problem with at least one of the two steps of identification and elimination.
Sometimes "recognition" will go wrong, because cancer cells are disguised and look like good people, and immune cells can't recognize them. Sometimes, the step of "elimination" goes wrong. Immune cells clearly recognize cancer cells, but they don't respond, and they become "onlookers eating melons." Usually, this is because cancer cells are smart, and they can send various signals to immune cells to inhibit their activity. Just like the bad guys give gifts to the police, let them "show mercy".
Immunotherapy is to repair these defects, help immune cells identify cancer cells, or help immune cells eliminate cancer cells.
The CAR-T immunocyte therapy used by Teacher Zhang is mainly to help identify cancer cells, while the immune checkpoint inhibitor is mainly to help eliminate cancer cells.
The advent of immunotherapy has completely changed the pattern of human fight against cancer. Some patients with only a few months to live have lived after treatment 10 years.
This is an outstanding contribution made by scientists such as Professor Allison and Professor Tasuku Honjo to mankind. Here, we once again congratulate Professor Allison and Professor Tasuku Honjo for winning the Nobel Prize in Physiology or Medicine. This is the best recognition of their contribution!
In fact, no matter how advanced the treatment of cancer is, it only turns cancer into a chronic disease, or just prolongs the life of patients. Therefore, in order to really stay away from the invasion of cancer, it is better to do regular cancer screening and cut off the signs of cancer.
Because if cancer is found early, it is usually not fatal, and it usually takes many years to brew. If it can be found in advance in this brewing time, it will be a benign tumor, and it will be fine if it is removed.
Japan ranks first in the world in early cancer screening capacity.
The cure rate of cancer reached 68%
In the prevention and treatment of major diseases, the gap between China and Japan in medical technology and cutting-edge equipment is self-evident.
In Japan, about 80% of cancers are found at an early stage, and 80% of them can be cured.
In China, the situation is just the opposite. More than 80% of cancers are diagnosed in the middle and late stages, and 80% of patients cannot be cured.
The cancer cure rate is 68% in Japan and 20% in China.
Anti-cancer physical examination has been very routine and popular in Japan, which is also one of the secrets of Japanese longevity.
In addition, if early cancer is found in Japan, it can be cured by simple minimally invasive surgery, which can prevent the spread and metastasis of cancer cells in time and avoid serious harm to the body.
Therefore, it is suggested that we must strengthen the awareness of cancer screening, have regular physical examinations, find cancer lesions earlier through accurate cancer screening, receive treatment earlier, reduce the difficulty of treatment and get rid of cancer from the source.