pdl1Lung cancer


What do you know about modern immunotherapy methods for the treatment of advanced lung cancer?

Can newer lung immunotherapy methods be more effective than chemotherapy and have fewer side effects and toxicity?

If you or those around you have advanced lung cancer and you want to know more about new methods of lung immunotherapy, we recommend that you read on.



What you will read next:



Immunotherapy or pd1 in lung cancers

What is pdi protein?

What is the meaning of PDL1?

What are the diseases associated with pdl1?

What do we do in the diagnostic process?

Now let's see how the treatment is done?

What is a set of immunotherapy in the treatment of cancer?

Lung cancer

How many types of lung cancer do we have?

How is lung cancer managed and treated?





Lung cancers are one of the leading causes of cancer-related deaths in the world. Non-small cell lung cancer accounts for more than 85% of all lung cancers.

Surgery and radiotherapy will not be considered a treatment option for these people. For about 5 years, research has been conducted to determine the antibodies that can stimulate the immune system of a person with cancer cells, And the combined use of these antibodies, called immunotherapy, is said to improve the outcome of patients with non-small cell lung cancer.


Immunotherapy or pd1 in lung cancers

Research shows that there are antibodies that can stimulate the immune system when they attach to their own receptors to show greater strength against cancer cells. These methods have been shown to have a positive effect on the survival of patients with lung cancer.

Following immunotherapy, inflammation of various tissues in the body can occur due to the activation of the immune system.


What is pdi protein?

What is pdi protein And what role can it play in immunotherapy and treatment of lung cancer is a question that we want to address further.

How much difference does immunotherapy make if it is given alone or in combination with other methods compared to standard chemotherapy, which is common for non-small cell lung cancer?

The above question is one of the topics that has been widely researched in the last five years.

Studies have compared chemotherapy for people with untreated non-small cell lung cancer with immunotherapy, which is antibodies that interact with specific proteins called immune checkpoints.

In a large study of about 6,000 patients with non-small cell lung cancer, this study is targeted.


What is the meaning of PDL1?

programmed death_Ligand1

The acronym is the above phrase, which also has other names, which are:




In fact, the above protein is a protein that will be encoded in humans by a specific gene called the CD274 gene, which inhibits human T lymphocytes by binding to a special receptor called the pd-l1 receptor.

Let’s See below how this protein works:

It is located on lymphocytes of the pd1 protein inhibitor.

On the other hand, pdl1 is expressed on tumor cells.


The first route


In the immune system, as a negative regulatory mechanism, it will prevent the body from over-activating T lymphocytes.

Cancer cells due to the above combination which occurs at the level of T lymphocyte, escapes from the immune system.

Thus, by combining the above, the immune system cannot suppress the tumor, so targeting this pathway uses specific monoclonal antibodies or small molecules that prevent the tumor from escaping the immune system.

The pd1 immune system is located on lymphocytes, and pdl1 is located on antigen-supplying cells, the two act as molecular inhibitors, and their interaction, as mentioned above, flexes the immune system against tumor cells.


What are the diseases associated with pdl1?

This protein is said to play a key role in suppressing the immune system during pregnancy. It can also play an important role in tissue transplants of autoimmune diseases and autoimmune hepatitis. Overproduction of this protein causes tumor cells to escape from the immune system.

For example, in research on malignant kidney tumors, if it is found that this protein has a significant effect on the surface of a person's tumor cells, this finding is equivalent to a more aggressive tumor and a four-and-a-half-fold increase in the risk of dying from kidney cancer in that person compared to someone who had less of this protein in their tumor cells.

Another point is that this protein also plays a major role in people with autoimmune diseases such as lupus.

Cancers in which this protein can be associated with mortality include non-small cell lung cancer, colorectal cancer, and kidney cancer.

In summary, if the expression of this protein in assessments in non-small cell lung tumors is high, it can be associated with increased malignancy and decreased survival.


What do we do in the diagnostic process?

Some tumors may produce pdl1-like signals, aimed at mimicking normal cells and thus escaping the immune system, when we insert the anti-pd1 antibody, the pd1 receptor recognizes and inhibits the pdl1 signal in tumor cells.

How the expression of pdl 1 in the tumor is determined is that the expression of this protein is measured by the amount of TPS, TPS stands for tumor proportion score, which is measured by the percentage of living tumor cells that show complete or incomplete membrane staining.

When the TPS of living tumor cells is more than 50% and they have presented membrane staining with any color intensity. Patients with more than 50% TPS are candidates for treatment with pd1 antibody.

Other methods that could determine this marker in the blood include immunohistochemistry.


Now let's see how the treatment is done?

Currently several pdl1 blockers is being researched and made to be used in various cancers. The results of clinical trials have also been good and acceptable. One of the above drugs is avelumab.

Recent research has shown that inhibitors against the compound pdl1 / pd1 can be a targeted treatment and a good target therapy that fully strengthens the immune system against tumor cells.

There is a drug called pembrolizumab that studies have shown that if we compare this drug with some common chemotherapy drugs, it can be a more effective treatment for advanced lung cancer in this advanced lung cancer, sometimes referred to as non-small cell lung cancer, the tumors express a biomarker called pdl1, which As mentioned above, it protects them from the immune system and their attacks, and therefore makes the tumor invincible against the immune system.


What is a set of immunotherapy in the treatment of cancer?

It is a type of new treatment of tumors that in practice strengthens the immune system against tumor cells, that is, strengthens the immune system in the fight against tumors.

Immunotherapy is a biological treatment or treatment that uses ingredients from living organs to treat cancer.


Lung cancer

Lung cancer is currently the leading cause of cancer death in both men and women.

Because cancer progresses or metastasizes very quickly when diagnosed, it is very dangerous and deadly and one of the most incurable tumors in humans.

The risk of lung cancer in a smoker is very high and is closely related to the years of consumption and the number of packs of cigarettes a person consumes daily. Exposure to secondhand smoke, ie passive smokers, can also lead to lung cancer.


How many types of lung cancer do we have?

Doctors generally say that there are two general types of lung cancer in terms of growth and expansion pattern.  One type of lung cancer is small cell carcinoma and the second is non-small cell lung carcinomas. It is better to give a brief explanation about non-small cell carcinoma. It is the most common type of lung cancer, which accounts for up to 85% of cases. These carcinomas are non-invasive and do not invade the surrounding tissues and will require immediate treatment. adenocarcinoma squamous cell carcinoma and large cell carcinoma and neuronal tumors of large cells are subsets of this category.

The other group is small cell lung carcinoma that is less common. About 15% of lung cancers have a high risk of metastasis. They grow and develop much faster than before and therefore can respond better to chemotherapy than non-small cell lung carcinoma.

However, small cell lung carcinoma is unlikely to be cured.

The third category is miscellaneous lung tumors.

Mesothelioma is a lung tumor that is associated with exposure to inhaled fiberglass or asbestos.


How is lung cancer managed and treated?

For successful treatment and management of cancer, there must be a treatment team. Treatment can be a combination of surgery, chemotherapy, targeted chemotherapy, radiation therapy and immunotherapy, which was the subject of this article. The choice of which method contributes the most to a person's health depends entirely on the location and stage of the tumor and the general condition and health of the affected person.


  • Surgery

Surgery is often the first treatment option to remove the cancer from the lungs and surrounding area and prevent it from spreading. Surgery can be a good option. Surgery can remove a lobe or larger part of the lung from the body. In severe cases, a whole lung may be removed.

The third method is radiation therapy before surgery:

The doctor may reduce the size of the tumor with radiotherapy, Radiation therapy is effective in treating cancers that are limited to a small area and have not spread.

Sometimes the combination of chemotherapy and radiotherapy before and after surgery results in higher therapeutic success.


  • Target therapy

Drugs used for this purpose are drugs that sit on certain cancer cells, that is, they target specific cells. For example, it stops the division of cancer cells. The systemic side effects of these drugs are less due to the fact that they act only on specific receptors.


  • The fourth method, which is new, is called immunotherapy

Immunotherapy actually uses the body's immune system to fight cancer.

Cancer cells express proteins on themselves that trick the immune system cells that come to fight them, thus protecting the tumor from immune system damage and allowing it to continue to grow and survive. With immunotherapy, we involve tumor cells in this process of escape and expose them to the attack of the individual's immune system.

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