EGFR nanovaccine in lung cancer treatment

Lung cancer is known as the most common malignancy in the world in terms of incidence and death rate. GLOBOCAN data in 2018 showed that its prevalence reaches 11.6% with mortality reaching 1.7 million annually. The prevalence of lung cancer in Indonesia is also considerably high; there were 25,332 cases in men and 9,374 cases in women with mortality reaching 308,660 people. In general lung cancer is classified as non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Although it is less common, SCLC has a worse prognosis with a 5 year survival rate of 6.4%. In addition, SCLC is also often diagnosed when it has metastasized or already reaced extensive stage (ES-SCLC). Although SCLC is classified as chemo-responsive cancer, the overall outcome of first-line and second-line therapy is still unsatisfactory with an ORR of 10-25%. One of characteristic of SCLC is genomic instability which relates to high level of mutations especially EGFR mutation that strongly correlate with therapeutic outcome. Therefore, targeting EGFR mutation is a sensible and potential field in developing SCLC therapy. EGFR-CpG-ODN nanovaccine is one of the potential therapeutic choices that exploit this mutation. EGFR CpG ODN nanovaccine could inhibit resistance to EGFR TKI, increased dendritic cell maturation, inhibit cancer cell proliferation and apoptosis, as well as enhance the anticancer immune response. Therefore, this therapeutic approach is a promising future therapy for SCLC petients that could improve patient’s survivability. ?Keywords: EGFR-CpG-ODN, EGFR mutation, Lung Cancer, nanovaccine