The Position of EGF Deprivation in the Management of Advanced Non-Small Cell Lung Cancer

Ramos, Tania Crombet; Santos-Morales, Orestes; Dy, Grace K.; Monzón, Kalet León; Dávila, Antonio

doi:10.3389/fonc.2021.639745

Cited by 11 publications

(7 citation statements)

References 103 publications

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“…This result suggests that subjects with squamous histology had greater benefits after vaccination since it is well accepted that the prognosis of adenocarcinoma patients is much better ( 40 , 41 ). Previous randomized clinical trials have also found a bigger effect in patients with squamous carcinomas, presumably associated with the greater expression of unmutated EGFR in this tumor type ( 42 ).…”

Section: Discussionmentioning

confidence: 84%

“…This is precisely what is expected. EGF concentration after front-line therapy in NSCLC has been proposed as a poor prognostic biomarker of the disease and also as a predictive biomarker of higher CIMAvax-EGF efficacy ( 18 , 42 ). It means that patients with low EGF have a better prognosis, while patients with high EGF would have a poorer prognosis but a larger survival gain with CIMAvax-EGF.…”

Section: Discussionmentioning

confidence: 99%

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Safety and effectiveness of CIMAvax-EGF administered in community polyclinics

Ortiz Carrodeguas,

Lorenzo Monteagudo,

Guerra Chaviano

et al. 2024

Front. Oncol.

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In spite of the advances in immunotherapy and targeted therapies, lung cancer continues to be the leading cause of cancer-related death. The epidermal growth factor receptor is an established target for non-small cell lung cancer (NSCLC), and its overactivation by the ligands can induce accelerated proliferation, angiogenesis, and metastasis as well as proinflammatory or immunosuppressive signals. CIMAvax-EGF is an epidermal growth factor (EGF)-depleting immunotherapy that is approved for the treatment of NSCLC patients in Cuba. The study was designed as a phase IV trial to characterize the safety and effectiveness of CIMAvax-EGF in advanced NSCLC patients treated in 119 community polyclinics and 24 hospitals. CIMAvax-EGF treatment consisted of four bi-weekly doses followed by monthly boosters. Overall, 741 NSCLC patients ineligible for further cancer-specific treatment were enrolled. CIMAvax-EGF was safe, and the most common adverse events consisted of mild-to-moderate injection site reactions, fever, chills, tremors, and headache. For patients completing the loading doses, the median survival was 9.9 months. For individuals achieving at least stable disease to the frontline and completing vaccination induction, the median survival was 12 months. Most of the functional activities and symptoms evaluated through the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire improved over time. In conclusion, this real-world trial demonstrated that CIMAvax-EGF was safe and effective in patients who were vaccinated in the maintenance scenario. A larger effect was seen in subjects with poor prognosis like those with squamous tumors and high EGF levels. Remarkably, this community-based intervention was very important because it demonstrated the feasibility of treating advanced lung cancer patients with active immunotherapy in primary care institutions. In addition to CIMAvax-EGF, patients received supportive care at the community clinic. Vaccine administration by the family doctors at the polyclinics reduced the patients’ burden on the medical oncology services that continued providing chemotherapy and other complex therapies. We conclude that community polyclinics constitute the optimal scenario for administering those cancer vaccines that are safe and require prolonged maintenance in patients with advanced cancer, despite the continuous deterioration of their general condition.Clinical trial registrationhttps://rpcec.sld.cu/trials/RPCEC00000205-En, identifier RPCEC00000205.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of CIMAvax-EGF administered in community polyclinics

Ortiz Carrodeguas,

Lorenzo Monteagudo,

Guerra Chaviano

et al. 2024

Front. Oncol.

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“…The negative control group with EGF was significantly lower than the positive experimental group added with EGF only. When different concentrations of EGF were added to lung adenocarcinoma A549 cells, the protein expression level of EGFR increased to different degrees [ 44 ]. Bombyx mori carboxypeptidase inhibitor can inhibit the rapid proliferation of gastric cancer cells induced by the addition of EGF, which indicates that the inhibitory activity of silkworm carboxypeptidase inhibitor is likely related to the downstream-related pathways initiated by EGF/EGFR.…”

Section: Discussionmentioning

confidence: 99%

The Silkworm Carboxypeptidase Inhibitor Prevents Gastric Cancer Cells’ Proliferation through the EGF/EGFR Signaling Pathway

Zhao

2023

IJMS

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Gastric cancer is a common malignant tumor originating from the gastric mucosa epithelium. Studies have shown that bioactive substances such as antimicrobial peptides and cantharidin contained in a variety of insects can exert anti-cancer functions; when compared with chemotherapy drugs, these bioactive substances have less toxicity and reduced side effects. Here, we report the first Bombyx mori carboxypeptidase inhibitor that is specifically and highly expressed in silk glands, which can significantly prevent the proliferation of gastric cancer cells by inhibiting the MAPK/ERK pathway initiated by EGF/EGFR through the promotion of expression of the proto-oncogene c-Myc, thereby affecting the expression of related cyclins. Through molecular docking and virtual screening of silkworm carboxypeptidase inhibitors and epidermal growth factor receptors, we identified a polypeptide that overlapped with existing small-molecule inhibitors of the receptor. In the present work, we explore the medicinal potential and application of silkworm carboxypeptidase inhibitors to promote the development of anti-tumor drugs from insect-derived substances.

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“…Recent trials have demonstrated efficacy in lengthening the median overall survival of NSCLC patients with stable disease 110 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of immunological agents in non‐small cell lung cancer

et al. 2022

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Background and aim: Non-small cell lung cancer (NSCLC) continues to claim millions of lives worldwide. Although its poor prognosis is largely attributed to the lack of adequate and precise detection technologies, cancer cells' suppression of the immune system adds on to the difficulty of identifying abnormal NSCLC tumors in their early stages. Therefore, cancer immunotherapy, which activates the immune system and helps it fight tumors, has recently become the most sought-after technique, especially in the advanced stages of NSCLC, where surgery or chemotherapy may or may not bring about the desired survival benefits in patients.Methods: This review focuses on the various immunotherapeutic interventions and their efficacy in advanced NSCLC clinical trials. Monoclonal antibodies like anti-PD-1/PD-L1 agents and anti-CTLA-4 antibodies, cancer vaccines, oncolytic viruses and adoptive T cell therapy have been discussed in brief. Furthermore, the effects of gender, age, and race on the efficacy of immune checkpoint inhibitors and suggest plausible future approaches in the realm of immuno-oncology.Results: Immunotherapy is used alone or in combination either with other immunological agents or with chemotherapy. However, the efficacy of these strategies depends extensively on various demographic variables, as some patients respond perfectly well to immunotherapy, while others do not benefit at all or experience disease progression. By targeting a "hallmark" of cancer (immune evasion), immunotherapy has transformed NSCLC management, though several barriers prevent its complete effectiveness.Conclusions: All these immunological strategies should be interpreted in the current setting of synergistic treatment, in which these agents can be combined with chemotherapy, radiotherapy, and, or surgery following patient and tumor characteristics to proportionate the best-individualized treatment and achieve superior results. To better pursue this goal, further investigations on cost-effectiveness and sex-gender, race, and age differences in immunotherapy are needed.

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The Position of EGF Deprivation in the Management of Advanced Non-Small Cell Lung Cancer

Cited by 11 publications

References 103 publications

Safety and effectiveness of CIMAvax-EGF administered in community polyclinics

Safety and effectiveness of CIMAvax-EGF administered in community polyclinics

The Silkworm Carboxypeptidase Inhibitor Prevents Gastric Cancer Cells’ Proliferation through the EGF/EGFR Signaling Pathway

Effectiveness of immunological agents in non‐small cell lung cancer

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