Immunotherapy of lung tumors

Abstract

Lung cancers are one of the biggest killers in the world, ranking in the top five of the most common tumors superseded by breast and prostate cancer only in some countries. The recent campaigns aimed at cessation of smoking have dramatically reduced cardiovascular events in some European countries. However, lung cancer remains an elusive disease with not much improvement in overall survival despite neoadjuvant chemotherapy, making this tumor a difficult burden to tackle even for the most advanced healthcare systems. Lung tumors were once rare before the nineteenth century. Smoking has dramatically contributed to the jump in numbers from the mid-1940s onward. A shift of histological subtypes has been noticed since the introduction of low-tar cigarettes making them at least more amenable for surgical resection. Over the last two decades, there has been increased enthusiasm in immunotherapy with emphasis on humoral and cellular treatment modalities. Only recently, two monoclonal antibodies (mAbs), ipilimumab and nivolumab (BMS936558), have dramatically changed the outcome of melanoma treatments which were once almost nonexistent. In a dramatic analogy, these monoclonal antibodies seem to have a significant effect on solid tumors as well as mainly lung tumors. This chapter will focus on the most studied and most advanced trials that have been available to us over the last 5 years with emphasis on their success or even their potential success. By no means will this chapter be comprehensive enough to discuss all the treatment challenges or the available therapies; thus, discretion is left to the reader to increase their knowledge base in pulmonary lung tumors with further readings in pathology and histology.