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Recent advances in treatment of advanced lung cancer, TB infection and
critical care of medicine.
Lung cancer is the leading cause of cancer-related death in Taiwan and
worldwide. For characteristics of lung cancers with highly invasive ability, early
metastasis and chemoresistance, the overall prognosis of lung cancer poor with
an overall 5-year survival rate less than 15%. Chemotherapy was the standard
treatment for patients with advanced disease and good performance status in the
past decades. The response rate of platinum-based regimens provided an overall
response rate around 30-40% and median survival time around 10 months. The
benefits provided by chemotherapy is not satisfied by patients also physicians.
In the early 21th century, epidermoid growth factor receptor (EGFR) tyrosine
kinase inhibitors (TKI) were applied in treating non-small cell lung cancer
patients. Adenocarcinoma, female and non-smoker were more likely response to
this kind of drug. The key factor decided whether patient will respond to EGFR
TKIs or not is the existence of certain mutations between EGFR exon 19 to 21
such as exon 19 deletions or L858R point mutation. The response rate as high as
70-80% and progression free survival over 10 month were remarkable in these
patients treated by EGFR TKIs. The EGFR-TKI has been suggested as the first-line
treatment in patients with lung adenocarcinoma harboring sensitizing mutations
in Taiwan. However, resistance happens after a mean time 10-12 months of
treatment. The third general generation of EGFR-TKIs have showed good results
in treating patients with acquired resistance of T790M mutation.
Immunotherapies are also the emerging therapeutic strategies in lung cancer.
Anti-MUCI vaccine, anti-CTLA-4, PD-1, PDL-1 monoclonal antibodies are all under
the clinical trials with promising results. Some checkpoint immunotherapies have
already proved by FDA for treating lung cancer.
In this symposium, we will review the recent advances in treatments of lung
cancers and also TB infection and critical care of medicine.