A prospective study on the role of immunotherapy in metastatic cancer patients at Combined Military Hospital Dhaka

Authors

  • M. Quadrat E. Elahi Department of Medical Oncology, Combined Military Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230694

Keywords:

Role, Immunotherapy, Pembrolizumab, Nivolumab, Atezolizumab, Metastatic cancer

Abstract

Background: Immunotherapy is a treatment that uses a person’s immune system to fight cancer. Immunotherapy can boost or change how the immune system works so it can find and attack cancer cells. Among several cancers, metastatic cancer causes high mortality, and immunotherapies are expected to be effective in the prevention and treatment of metastatic cancer patients. In Bangladesh, we do have not enough research-based information regarding the role of immunotherapy in treating metastatic cancer patients. This study aimed to assess the role of immunotherapy in treating metastatic cancer patients.

Methods: This prospective observational study was conducted in combined military hospital Dhaka, Bangladesh during the period from 26 March 2021 to 21 July 2022. In total 19 patients with metastatic cancer were enrolled in this study as study subjects. Proper written consent was taken from all the participants before data collection. Two (02) different outcomes were studied in this study; progression-free survival (PFS) and side effect percentages. A predesigned questionnaire was used in data collection. All data were processed, analyzed, and disseminated by using MS excel and SPSS version 23 program as per necessity.

Results: In using pembrolizumab, side effects, fatigue, nausea, and decreased appetite were found 43%, 22%, and 20% lesser respectively than chemotherapy which was noticeable. In using nivolumab, as a side effect, skin rash was found 66% lesser than chemotherapy. Besides this, itching, face swelling, and apnea was found 33% lesser. On the other hand, in using atezolizumab, as side effects, swelling of arms and constipation were found 66% lesser, and itching, as well as apnea, was found 33% lesser than that in chemotherapy. At the 6-month follow-up we observed that in the nivolumab and atezolizumab treated groups 66% of cases survived separately whereas, in pembrolizumab treated group, 61% survived.

Conclusions: In this study in all treatment groups, side effects were found as lesser than that in using chemotherapy. No major complication of any patients was observed in this study. So, can conclude that immune checkpoint inhibitors (ICIs) are better choice for metastatic diseases and ICIs exert lesser side effects than conventional chemotherapies.

References

Tian T, Olson S, Whitacre JM. The origins of cancer robustness and evolvability. Integr Biol (Camb). 2011;3:17-30.

Castle JC, Kreiter S, Diekmann J. Exploiting the mutanome for tumor vaccination. Cancer Res. 2012;72:1081-91.

Chen DS, Mellman I. Elements of cancer immunity and the cancer immune set point. Nature. 2017;541:321-30.

Foley EJ. Antigenic properties of methylcholanthrene-induced tumors in mice of the strain of origin. Cancer Res. 1953;13:835-7.

Sahin U, Türeci Ö. Personalized vaccines for cancer immuno-therapy. Science. 2018;359:1355-60.

Van der Bruggen P, Traversari C, Chomez P. A gene encod- ing an antigen recognized by cytolytic T lymphocytes on a human melanoma. Science. 1991;254:1643-7.

Hu Z, Ott PA, Wu CJ. Towards personalized, tumour-specific, therapeutic vaccines for cancer. Nat Rev Immunol. 2018;18:168-82.

Chen DS, Irving BA, Hodi FS. Molecular pathways: next generation immunotherapy-inhibiting programmed death-ligand 1 and programmed death. Clin Cancer Res. 2012;18:6580-7.

Mullard A. New checkpoint inhibitors ride the immunotherapy tsunami. Nat Rev Drug Discov. 2013;12:489-92.

Chen DS, Mellman I. Oncology meets immunology: the Cancer-Immunity Cycle. Immunity. 2013;39:1-10.

Rapoport AP, Stadtmauer EA, Binder-Scholl GK. NY-ESO-1- specific TCR-engineered T cells mediate sustained antigen-specific antitumor effects in myeloma. Nat Med. 2015;21:914-21.

World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Heal Organ. 2001;79(‎4):373-4. Available at: https://apps.who.int/iris/handle/10665/ 268312. Accessed on 10 January 2023.

Voigt P, Von dem Bussche A. Enforcement and fines under the GDPR. The EU General Data Protection Regulation (GDPR). Springer, Cham. 2017;201-17.

Marabelle A, Fakih M, Lopez J. Association of tumour mutational burden with outcomes in patients with advanced solid tumours treated with pembrolizumab: prospective biomarker analysis of the multicohort, open- label, phase 2 KEYNOTE-158 study. Lancet Oncol. 2020;21(10):1353-65.

Fukuoka S, Hara H, Takahashi N, et al. Regorafenib plus nivolumab in patients with advanced gastric or colorectal cancer: an open-label, dose-escalation, and dose-expansion phase I b trial (regonivo, EPOC1603). J Clin Oncol. 2020;38(18):2053-61.

Le DT, Uram JN, Wang H. PD-1 blockade in tumors with mismatch-repair deficiency. N Engl J Med. 2015;372(26):2509-20.

O’Neil BH, Wallmark JM, Lorente D. Safety and antitumor activity of the anti-PD-1 antibody pembrolizumab in patients with advanced colorectal carcinoma. PLoS One. 2017;12(12):e0189848.

Eng C, Kim TW, Bendell J. IMblaze370 Investigators. Atezolizumab with or without cobimetinib versus regorafenib in previously treated metastatic colorectal cancer (IMblaze370): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2019;20(6):849-61.

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Published

2023-03-17

How to Cite

M. Quadrat E. Elahi. (2023). A prospective study on the role of immunotherapy in metastatic cancer patients at Combined Military Hospital Dhaka. International Journal of Research in Medical Sciences, 11(4), 1056–1059. https://doi.org/10.18203/2320-6012.ijrms20230694

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Section

Original Research Articles