Background
Lung cancer is the second most common cancer and the leading cause of cancer related deaths in the United States. Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancers. NSCLC has three subtypes: adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. Squamous cell carcinoma is found in the central part of the lungs and is often linked to smoking. Adenocarcinoma arises from the bronchial mucosal glands and is the most common of the three subtypes. Large cell carcinoma can be found in any part of the lungs and tends to grow and spread quickly. The development of non-small cell lung cancer involves the loss of heterogeneity of tumor suppressor genes, such as Ras, p16, and p53. In some patients, a mutation …show more content…
PD-1 is an immune checkpoint receptor expressed on T-cells. When PD-1 binds to its ligand (PD-L1), the immune response is suppressed. This pathway is misused by cancer cells to protect themselves from the antitumor response. Pembrolizumab works by blocking this interaction between PD-1 and PD-L1, thereby activating the immune response against the cancer cells. There is a test available now called PD-L1 IHC 22C3 pharmDx test to detect the PD-L1 expression in non-small cell lung tumors. 4
Adverse Reactions/Warnings/Precautions
The most common adverse reactions reported were fatigue, cough, decreased appetite, and dyspnea. If an infusion reaction occurs, then the infusion must be stopped and pembrolizumab must be permanently discontinued if a severe reaction occurs. Pembrolizumab may cause fetal harm and therefore should not be used during pregnancy. It is unknown if it excreted into the breastmilk. Pembrolizumab can cause immune-mediated side effects involving the lungs, colon, liver, kidneys, and hormone-producing glands. For all these side effects, treatment should be withheld and for some conditions be permanently discontinued.
Lung cancer is the second most common cancer and the leading cause of cancer related deaths in the United States. Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancers. NSCLC has three subtypes: adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. Squamous cell carcinoma is found in the central part of the lungs and is often linked to smoking. Adenocarcinoma arises from the bronchial mucosal glands and is the most common of the three subtypes. Large cell carcinoma can be found in any part of the lungs and tends to grow and spread quickly. The development of non-small cell lung cancer involves the loss of heterogeneity of tumor suppressor genes, such as Ras, p16, and p53. In some patients, a mutation …show more content…
PD-1 is an immune checkpoint receptor expressed on T-cells. When PD-1 binds to its ligand (PD-L1), the immune response is suppressed. This pathway is misused by cancer cells to protect themselves from the antitumor response. Pembrolizumab works by blocking this interaction between PD-1 and PD-L1, thereby activating the immune response against the cancer cells. There is a test available now called PD-L1 IHC 22C3 pharmDx test to detect the PD-L1 expression in non-small cell lung tumors. 4
Adverse Reactions/Warnings/Precautions
The most common adverse reactions reported were fatigue, cough, decreased appetite, and dyspnea. If an infusion reaction occurs, then the infusion must be stopped and pembrolizumab must be permanently discontinued if a severe reaction occurs. Pembrolizumab may cause fetal harm and therefore should not be used during pregnancy. It is unknown if it excreted into the breastmilk. Pembrolizumab can cause immune-mediated side effects involving the lungs, colon, liver, kidneys, and hormone-producing glands. For all these side effects, treatment should be withheld and for some conditions be permanently discontinued.