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Complications following novel therapies for non-small cell lung cancer
Marcus Skribek1,2, Konstantinos Rounis2, Georgios Tsakonas1,2
1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Abstract:
The emergence of tyrosine kinase inhibitors and immune checkpoint inhibitors has paved a new era for the management of non-small cell lung cancer, which has for many years lacked major clinical breakthroughs. Historically, 5-year overall survival remained below 5% in individuals with metastatic disease. These novel treatments have led to significant prolongation of survival in the locally advanced and metastatic setting, exceeding 25% in selected populations. However, they present new challenges to clinicians due to their inherently different spectrum of toxicity unique to each specific drug's pharmacodynamic profile. Internists commonly come across these side effects in their daily clinical practice. Their optimal recognition and management are of utmost importance, because it is associated with significant improvements in patient survival outcomes and their quality of life. The aim of this review is to summarize the complications following these novel treatments for non-small cell lung cancer.
Insights
Novel cancer therapies like tyrosine kinase inhibitors and immune checkpoint inhibitors improve non-small cell lung cancer survival. This review details their unique toxicities and management for internists.
Area of Science:
- Oncology
- Pharmacology
- Internal Medicine
Background:
- Non-small cell lung cancer (NSCLC) management has been revolutionized by tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs).
- Historically, 5-year survival for metastatic NSCLC was below 5%, but novel therapies now exceed 25% in some populations.
- These advancements introduce unique drug-specific toxicities requiring internist recognition and management.
Purpose of the Study:
- To review the spectrum of complications associated with novel TKIs and ICIs in non-small cell lung cancer.
- To provide guidance for internists on recognizing and managing these treatment-related toxicities.
- To emphasize the importance of managing side effects for improved patient survival and quality of life.
Main Methods:
- Literature review of recent clinical trials and observational studies on TKI and ICI therapy for NSCLC.
- Analysis of reported adverse events and their management strategies.
- Synthesis of information relevant to internists' clinical practice.
Main Results:
- TKIs and ICIs significantly improve survival outcomes in advanced NSCLC.
- These therapies exhibit distinct toxicity profiles, including immune-related adverse events and specific organ toxicities.
- Effective management of toxicities is crucial for maintaining treatment efficacy and patient well-being.
Conclusions:
- Novel targeted therapies and immunotherapies represent a paradigm shift in NSCLC treatment.
- Understanding and managing the unique toxicities of these drugs is essential for internists.
- Optimized management of side effects can lead to better patient survival and quality of life in NSCLC.
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