Κατεύθυνση Κλινικοπαθολογοανατομική θεώρηση των νεοπλασιών του ανθρώπου
Library of the School of Health Sciences

2020-11-02

2020

Papadoula Christiana

Ανδρέας Χ. Λάζαρης, Καθηγητής, Ιατρικη Σχολη, ΕΚΠΑ
Θυμαρά Ειρήνη, Καθηγήτρια, Ιατρικη Σχολη, ΕΚΠΑ
Σακελλαρίου Στρατηγουλα, Καθηγητρια, Ιατρικη Σχολη, ΕΚΠΑ

Ανοσοϊστοχημικές τεχνικές μέθοδοι ανίχνευσης των βιοδεικτών ALK και PDL-1 στην στοχεύουσα θεραπεία καρκινοπαθών πνεύμονα

Greek

Immunohistochemical technical methods for the detection of ALK and PDL-1 biomarkers in the targeted therapy of lung cancer patients

Α revolution in treating the so frequent and fatal non-small-cell lung carcinoma is brought by immunotherapy with the creation of new drugs, the check-point inhibitors which signifies the end of the chemotherapy era and composes the milestone therapy for some patients. These drugs, instead of attacking the cancer cell themselves, release the T cells of the organism, the “guardians” of the immune system, in order to attack the tumor. Furthermore, patients show a pronounced better quality of life as they do not show the toxic side-effects of the “traditional” cancer therapy, a therapy which benefits only a portion of the patients. Modern immunotherapy has taken advantage of this knowledge and with the help of clinical research has proven to be a pylon in cancer treatment which has shown significant increases in progression-free survival rates and overall survival rates.
The aim of immunotherapy is the up- regulation of the immune system for a more effective reaction against cancer.
The initial systemic therapy should be personalized keeping in mind features as the histological subtype, the molecular characteristics of the tumor, the age, the general status of the patient, his comorbidities and his preferences.
Immunotherapy has set the definitions of complimentary and companion diagnostic procedures by which every drug to be used has been locked to a specific immunohistochemical assay based on a specific antibody, an immunohistochemical platform, an interpretation protocol and control tissues. This procedure is either necessary for the administration of the drug or is used as a tool for the estimation of the benefit of the treatment.
Again in non-small-cell lung carcinomas,as Slight reversal within chromosome 2p was observed which resulted in the formation of protein with ALK-kinase activity, an important step in carcinogenesis. Although treatment with an ALK-inhibitor has not shown significant increases in survival rates, it has shown response rates and reduction of the symptoms of the disease. A lab test which will recognize the ALK translocations is required to indicate which patients will benefit from the treatment. This is done immunohistochemically by the CDx ALK (D5F3) analysis and molecularly by in situ hybridization.
It should be noted that the emerging progress in immunotherapy and personalized treatment is based on verified diagnostic procedures with strict staining protocols, ready-to-use antibodies, constant quality evaluation with controls and special algorithms for the evaluation and interpretation of the stain, all done by trained medical and technical personnel.

Health Sciences

ALK,PDL-1, Lung carcinoma

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https://pergamos.lib.uoa.gr/uoa/dl/object/2926767