Answer:
Traditionally, lung cancer was treated with surgery, chemotherapy, and radiation therapy. In recent years, targeted therapy and immunotherapy have emerged as new treatment options. Targeted therapy uses specific drugs for patients with gene mutations, such as EGFR, ALK, and ROS1 mutations, commonly found in lung cancer.
Unlike chemotherapy, which uses cytotoxic drugs that affect both cancerous and healthy cells, targeted therapy precisely targets cancer cells. This approach reduces side effects, improves treatment efficacy, and enhances the patient's quality of life.
The US Food and Drug Administration (FDA) has approved over 10 targeted therapies for lung cancer patients. However, each drug is only effective for specific cancer-causing gene mutations. Therefore, doctors often recommend gene testing to identify which mutations a patient has that can be targeted with existing therapies.
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Histopathology and immunohistochemistry testing for cancer patients. Photo: Tam Anh General Hospital |
Histopathology and immunohistochemistry testing for cancer patients. Photo: Tam Anh General Hospital
For immunotherapy, doctors use immune tests, specifically the PD-L1 test, to determine if a patient is suitable for this treatment. PD-L1 is a protein found on the surface of lung cancer cells that can block the immune system from attacking the tumor.
The PD-L1 test is performed on a tumor tissue sample to measure the expression level of this protein. The results are typically reported as a percentage, indicating the proportion of cancer cells expressing PD-L1. If the PD-L1 level is high, above 50%, the patient is likely to respond to PD-L1 inhibitor drugs. The higher the percentage, the better the potential response to immunotherapy.
Gene and immune testing are now routinely performed at many major hospitals, including Tam Anh General Hospital in Hanoi. Patients only need a single biopsy for testing, eliminating the need for multiple bronchoscopies. This saves time and cost compared to separate immune and individual gene tests.
Based on the results of these tests, doctors can personalize treatment plans. For example, if a patient has a gene mutation for which a targeted therapy is available, that treatment will be prioritized. If the patient does not have a suitable mutation for targeted therapy but has a high PD-L1 expression, immunotherapy may be recommended.
MSc. Dr. Vuong Ngoc Duong
Deputy Head of Radiation Therapy Department
Tam Anh General Hospital, Hanoi
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