Are all lung cancer patients fit for immunisation treatment? Lung cancer, as one of the malignant neoplasms with very high morbidity and mortality rates worldwide [1], is treated in a variety of ways, including surgery, chemotherapy, decomposition and emerging immunotherapy. Immunization treatment, as an innovative means of cancer treatment, attacks on cancer cells through activation or enhancement of the patient ‘ s own immune system, have shown remarkable efficacy in a wide range of cancer treatments. However, not all lung cancer patients are eligible for immunization treatment. This paper will explore the suitability of lung cancer patients for immunisation treatment and discuss attention during immunization treatment.Are lung cancer patients fit for immunisation treatment?The applicability of immunisation treatment depends on a number of factors, including the type of lung cancer, the phasing, the overall health status of the patient and the existence of certain biomarkers. For example, the expression level of procedural death formulation 1 (PD-L1) is one of the important biological markers for predicting the immune treatment response of patients with non-small cell lung cancer (NSCLC).[2] Patients with high PD-L1 expression are more likely to benefit from immunization treatment. In addition, tumour mutation loads (TMBs) may also be a marker for predicting the effects of immunotherapy[3]. Therefore, a detailed assessment of the patient and the necessary biomarker testing are required before a decision is made on immunization treatment.People covered by immunization treatmentPD-L1 high expression patient: PD-L1 level of expression is related to the efficacy of immunisation treatment, and high expression is more likely to respond to immunisation treatment.2. Patients with high tumour mutation load (TMB): Patients with high TMB may have a better response to immunisation treatment.3. Patients with non-drive genetic mutations: Immunization treatment may be an option for patients with genetic mutagenic negatives such as EGFR and ALK.4. Patients with advanced or transmissible lung cancer: Immunization treatment offers new treatment options for terminal lung cancer patients who cannot be operated or administered, with the opportunity to reduce the risk of surgery opportunities or to delay tumour progress to improve the condition.People not covered by immunization treatment1. Persons with self-immunological diseases: The use of immuno-immunological treatment by persons with self-immunological diseases may aggravate the condition.2. Patients with severe infections: Patients with severe infections, such as active tuberculosis, may be aggravated by the use of immunotherapy.3. Immunotherapy patients: Immunotherapy patients are not suitable for use.4. Cardiac disease: Certain heart disease patients, such as heart disorders, may be at risk of using immunotherapy.Attention during immunization treatmentThe following are some of the important concerns for patients with lung cancer who are receiving immunization treatment:1. Monitoring of side effects: Immunotherapy can cause immuno-related adverse events (irAEs), including dermal reactions, intestinal problems, liver toxicity, endocrine diseases, etc. Regular monitoring and timely identification of these side effects are therefore essential to ensure patient safety.2. A reasonable lifestyle: Patients should maintain a healthy lifestyle, including balanced diet, adequate exercise and adequate sleep to enhance physical resistance.3. Avoiding infection: As immunisation treatment may affect the immune system, patients should avoid exposure to sources of infection, such as sick people or animals, and to personal hygiene.4. Periodic screening: During immunisation treatment, patients are required to conduct regular blood and video screenings to assess the effectiveness of treatment and monitor potential side effects.5. Compliance with medical instructions: patients should use immunotherapy drugs in strict compliance with medical instructions and report promptly any discomfort or side effects.6. Psychological support: There may be psychological problems such as anxiety and depression in cancer treatment, and patients may seek psychological counselling or support groups.7. Drug interaction: Patients should inform doctors of all drugs being used, including prescriptions, non-prescriptions and supplements, in order to avoid potential drug interaction.8. Consideration of special population groups: Pregnant women, nursing women and children need special consultations with doctors before using immunisation treatment because of the limited availability of safe data on the use of immunisation treatment.9. Financial burden: Immunisation treatment may impose a higher financial burden and patients should discuss with doctors possible economic assistance programmes.10. Long-term follow-up: Even after the end of the treatment, patients should undergo long-term follow-up visits to monitor possible delayed side effects or relapses.
In general, immunization treatment provides new treatment options for patients with lung cancer, but the suitability for immunization requires a combination of factors and attention during treatment to ensure that treatment is safe and effective. Patients should work closely with the medical team to develop the best treatment. As research on immunotherapy progresses, there may be more predictive markers and treatment strategies in the future to provide more personalized treatment options for patients with lung cancer.
References:[1] Wang Yu Xin, Pan Kei and Li Wengqing, read in 2022 Global Cancer Statistics Report. Electronic magazine for comprehensive treatment of oncology, 2024.10(3): pp. 1-16.[2]. Wang Ting and Zhu Fonglin, progress of research on prognosis for non-small cell lung cancer PD-1/PD-L1 immunotherapy. Hainan Medicine, 2020.31 (13): 1737-1740.[3]. Yellow-hearing rain, etc., analysis of the predicted effects of sero-TMB-level tests on the immune effects of malignant neoplasm treatment. China Practical Medicine, 2024.19(7): pp. 37-41. Lung cancer
