Immunotherapy – new perspective in lung cancer

Lung carcinoma is associated with a high mortality worldwide,being the leading cause of cancer death.It is mainly classified into squamous non-small cell lung cancer(NSCLC),non-squamous NSCLC,and small cell lung cancer.However,such malignancy has been increasingly subdivided into histological and molecular subtypes to guide treatment.Therapies can be used in adjuvant and palliative settings.Regarding immunotherapy,it has been widely tested in both first or subsequent palliative lines.In this sense,drugs such as pembrolizumab,nivolumab,atezolizumab,ipilimumab,avelumab,and durvalumab have been assessed in large studies.Some of these trials have also studied these medicines in adjuvant and in maintenance therapy.In recent years,advances in immunotherapy have raised the hope that the unfavorable prognosis observed in several affected individuals can be changed.Immunotherapy has increased the overall survival in squamous NSCLC,non-squamous NSCLC,and small cell lung cancer.However,it has added to the oncology practice some side effects that are unusual in standard chemotherapy and require special clinical support.In order to show how immunotherapy is being applied in the treatment of lung carcinoma,we reviewed the main studies in adjuvant and palliative scenarios.What is the better scheme?What is the better combination?What is the better dose?When should we use immunotherapy?Does programmed cell death ligand 1 expression significantly interfere in immunotherapy efficiency?Some of these questions have already been answered,while others require more investigations.

Probiotics in inflammatory bowel disease:Does it work?

The number of patients with inflammatory bowel disease(IBD),a group of diseases mainly represented by Crohn’s disease(CD)and ulcerative colitis(UC),has increased in recent decades.As a consequence,the number of people undergoing any drug treatment against these diseases has expanded.However,IBD conventional therapies present several limitations,which lead researchers to look for better alternatives to improve the quality of life of patients.Moreover,microbiome imbalance seems to play a crucial role in the pathogenesis of IBD,since important alterations in bacterial,viral,protist and fungal populations are observed in the gut microbiota of affected individuals.Given the importance of such life forms in that context,the use of probiotics becomes a plausible alternative for treating affected patients.Trials have been developed aiming the evaluation of probiotics potential to induce and to maintain remission in CD and UC.Regarding the tested microorganisms,various non-pathogenic bacteria and fungi have been assessed.However,consistent results have been obtained only with some of them,including Escherichia coli Nissle 1917,VSL#3,Saccharomyces boulardii,Lactobacillus,and Bifidobacterium.Therefore,this minireview aims to explore the role of microbiota in the genesis of such a disorder and to compile the most concrete data on probiotic-related efficiency in IBD treatment.