Terapie

Terapie per il tumore al polmone

La principale differenza nell’approccio terapeutico del tumore del polmone non a piccole cellule (NSCLC) rispetto a quello a piccole cellule o microcitoma (SCLC) è rappresentata dal fatto che per quest’ultimo, anche se in stadio limitato, la strategia chirurgica viene adottata solo in casi molto selezionati.

Una volta completato l’iter diagnostico con la stadiazione (⇒ per saperne di più) e la diagnosi molecolare (⇒ per saperne di più), l’oncologo ha a disposizione tutti gli elementi per scegliere la strategia terapeutica più appropriata al paziente.

Indichiamo di seguito le opzioni terapeutiche attualmente impiegate nella cura del tumore del polmone, ricordando che hanno un valore informativo.

• CHIRURGIA ⇒ Per saperne di più

• RADIOTERAPIA ⇒ Per saperne di più
• CHEMIOTERAPIA ⇒ Per saperne di più
• MEDICINA PERSONALIZZATA (Immunoterapia, Terapie a Bersaglio molecolare) ⇒ Per saperne di più

• CURE DI SUPPORTO E PALLIATIVE ⇒ Per saperne di più

Hereafter we give a general picture of the major therapies presently used in the treatment of lung cancer. This general view is merely for information. The choice of the different options is made by the oncologist on a case-by-case basis, depending on the type and stage of the tumour to be treated.

Surgery

Total or partial removal of the tumour by surgery is normally used mainly in the first stages of the disease and in patients in good general conditions on the basis of the preliminary diagnostic studies which establish the benefits of this approach versus other treatment options. Surgery can be preceded or followed by cycles of chemotherapy or radiation therapy. In such a case these treatments aim at reducing the tumour mass (before surgery) or the risk of recurrence (after surgery).

Radiation Therapy

Radiation therapy uses high power radiations in order to destroy / reduce the tumour mass thus limiting at most damages to nearby healthy tissue. radiation therapy is variously used in the treatment of lung cancer depending on the type and stage of the tumour involved. In particular, it can be used alone or after surgery, as well as after chemotherapy to improve its effectiveness. It is important to emphasise how radiation therapy can play an important role in the reduction of pain symptoms in any stage of the disease.

Chemotherapy

Chemotherapy makes use of the so-called antiblastic or cytotossic drugs capable of inhibiting (blocking) the growth of tumour cells.

Chemotherapeutic drugs are variously used depending on the type of tumour to treat and as to the oncologist’s evaluation (the so-called adjuvant therapy) they may be given according to different regimens.: before surgery or radiation therapy (the so-called neoadjuvant therapy) to reduce the tumour mass and improve the outcome of such treatments, after surgery, to reduce the risk of recurrence, or as major therapeutic option, e.g. in case of small cell lung carcinoma. An appropriate use of chemotherapeutic drugs allows a better quality of life to patients and a reduction of symptoms.

Target Therapy or Biological Agents

Biologics are a new class of drugs capable of detecting and attacking with precision and selectivity tumour cells blocking a few mechanisms related to their growth, progression and spread (metastases) without generally injuring healthy cells. The most common side effects of chemotherapy can be avoided by using such drugs which are the fruits of the most advanced research and represent a new frontier towards the development of more effective and better tolerated treatment regimens.

They are used alone or in association with chemotherapy in order to obtain a better control of the tumour mass.

PRESS RELEASE: MAGE-GSK  (pdf) ↓

Lung cancer adenocarcinoma patients benefit from personalized treatment – Article  (Word) | Article (pdf) ↓

Clinical Trial: What is a clinical trial?

A clinical trial is a search mode through which new drugs and/or new therapeutic strategies are studied. You should know that any therapy doctors will propose is the result of a clinical study conducted in the past on people with your disease.

The participation in a clinical trial always helps the research to make progress, but it is important to have all the information about some studies evaluate a new drug in comparison with a standard therapy, other the administration mode of a drug (ie whether it is better to administer a chemotherapy every 15 days instead of every 28), mainly to improve their tolerability (ie to find a way that gives less side effects).

There are studies that evaluate if the addition of a new drug to standard therapy may give better outcomes, others seeking the best dose of a new drug, and others evaluating the possibility of combining more drugs together, and so on. There are clinical trials for all types and stages of disease aiming to improve the control of the disease, to decrease the chances of relapse after the end of treatment, to reduce side effects of therapies, to personalize care (to give the most appropriate and less toxic medication to suitable person for that treatment).

You can ask your doctor if that structure offer one or more clinical studies to participate. In any case it is important you know what it is, how the treatment works, what the study purpose is and what it would be different from the standard therapy (ie not as part of a clinical trial). The clinical studies provide criteria for inclusion (ie the characteristics of the person and the disease that allow to join the study) and exclusion (ie the characteristics of the person and the disease that prevents them from joining the study): your doctor will verify if you are candidate for the specific study or not.

There are studies called “randomized”, namely treatment decided (in the context of those provided by the study) random, so that you and/or the doctor lean towards one rather than another care. Before entering the study and after you have received all the information, you will be asked to sign an informed consent. It is still your right to decide to quit the trial (ie to stop that type of care) at any time, as the doctor may decide to let you quit the clinical trial if he/she believes that this is not the appropriate treatment for you (for lack of efficacy or excessive toxicity).

Before participating in a clinical trial these are the questions for your doctor to better understand and manage the disease:

• What are the inclusion and exclusion criteria for this study?
• And considering them, am I a right candidates for it?
• What are the possible side effects of treatment that I am going to receive?
• What can it change for me to participate in this study, rather than follow a standard care? 
• Shall I make additional tests?
• I know I can stop the clinical trial therapy at any time (or you can choose to do it for medical reasons): in this case what can you do for my disease?

Related File

“Immuno-Oncology Therapies to Treat Lung Cancer” (pdf)

“Targeted Therapy in Lung Cancer” (pdf)

“Targeted Therapies – how you can manage the most common side effects” (pdf)

“Supportive care in lung cancer” (pdf)