Lung carcinoma is associated with a high mortality worldwide, being the leading cause of cancer death. It is mainly classified into squamous non-small cell lung cancer (NSCLC), non-squamous NSCLC, and small cell lung cancer. However, such malignancy has been increasingly subdivided into histological and molecular subtypes to guide treatment. Therapies can be used in adjuvant and palliative settings. Regarding immunotherapy, it has been widely tested in both first or subsequent palliative lines. In this sense, drugs such as pembrolizumab, nivolumab, atezolizumab, ipilimumab, avelumab, and durvalumab have been assessed in large studies. Some of these trials have also studied these medicines in adjuvant and in maintenance therapy. In recent years, advances in immunotherapy have raised the hope that the unfavorable prognosis observed in several affected individuals can be changed. Immunotherapy has increased the overall survival in squamous NSCLC, non-squamous NSCLC, and small cell lung cancer. However, it has added to the oncology practice some side effects that are unusual in standard chemotherapy and require special clinical support. In order to show how immunotherapy is being applied in the treatment of lung carcinoma, we reviewed the main studies in adjuvant and palliative scenarios. What is the better scheme? What is the better combination? What is the better dose? When should we use immunotherapy? Does programmed cell death ligand 1 expression significantly interfere in immunotherapy efficiency? Some of these questions have already been answered, while others require more investigations.
Objetivo: Compreender os principais aspectos relacionados a interrupção dos tratamentos oncológicos durante a pandemia de COVID-19 e os aspectos psicológicos envolvidos. Revisão bibliográfica: A pandemia COVID-19 impactou diretamente no tratamento de pacientes oncológicos. Além disso, esses pacientes possuem maior probabilidade do que a população geral de serem infectados, ou de desenvolverem fenótipos graves do COVID-19 devido seu estado imunodeprimido, somado a visitas frequentes aos hospitais como ponto de infecção e das terapias imunossupressoras para o tratamento do câncer, além de fatores de risco adicionais a depender da idade e tipo de câncer. Ademais, os paciente oncológicos tem níveis aumentados de estresse percebido e pós-traumático atenuado com a quarentena e o contexto vigente de instabilidades. Sendo evidenciado a coronofobia como causa da elevação dos níveis de depressão, ansiedade generalizada e tanafobia em comparação aos anteriores a pandemia. Considerações finais: Nesta perspectiva, torna-se necessário maiores pesquisas sobre o impacto da pandemia no tratamento de pacientes oncológicos, sobre a interação do câncer com o COVID-19 e fornecimento de suporte psicossocial a essa população.
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