Published: Sat, April 21, 2018
Economy | By Melissa Porter

New drug could be game changer in treating lung cancer

New drug could be game changer in treating lung cancer

While magnitude of the survival benefit in the late-stage study was not yet known, the Keytruda combination cut the risk of death by 51 percent compared with chemotherapy and significantly delayed disease worsening, according to data presented on Monday.

A drug that acts on the immune system appears to help extend the lives of patients with advanced lung cancer when given alongside standard chemotherapy, a new study finds.

[Editor's note: Ben Fidler co-authored this report.] A decade from now, it's possible that immunotherapy will have made a big dent in lung cancer, which is by far the deadliest type of the disease.

The study results only apply to patients whose lung cancer does not start in the surface lung cell layer, or squamous cells, and who also do not have certain genetic mutations.

Two promising new studies suggest that combining immune therapy drugs with chemotherapy may improve survival. In the trial, Opdivo and Yervoy had no benefit for patients with a TMB score below 10. Patients in the study had advanced non-small cell lung cancer.

And the new results, released at an American Association for Cancer Research conference in Chicago and published in the New England Journal of Medicine, show more creative use of the drugs could change the way doctors treat lung cancer. The studies were sponsored by the drugmakers, and many study leaders and Herbst consult for the companies.

The trial was still a success, said Memorial Sloan Kettering oncologist Dr. Matthew Hellmann, because it established Opdivo and Yervoy as a chemo-free option for patients with high TMB. In addition, the patients' immune systems also likely destroyed straggler tumor cells still circulating in the blood system, which can later take hold and lead to recurrence and metastasis.

"Non-small cell lung cancer is actually the leading cause of cancer death in the world even though it's not the most common cancer", said Dr. Leena Gandhi, lead investigator of the study and director of the thoracic medical oncology program at Perlmutter Cancer Center at NYU Langone Health. "We are hopeful this breakthrough, and the follow-up clinical studies already under way, will translate into a new standard of care".

But, patients in the immunotherapy group had more kidney problems, more immune-related adverse events and were more likely to stop treatment because of side effects.

In addition, the median "progression-free survival time", or the time patients went without their disease getting worse, was almost nine months in the immunotherapy group, compared with five months in the control group. "This study is emblematic of SU2C's focus on Cancer Interception, finding new treatment approaches to intervene in the natural development of cancer, so that cancer patients may become long-term survivors".

Still, the drug has side effects - notably, about 5 percent of patients in the immunotherapy group experienced acute kidney problems, compared with 0.5 percent of patients in the control group.

Of 679 patients, 299 had a high number of gene flaws in their tumors. The median overall survival was 11.3 months in those who did not receive immunotherapy, whereas survival in the immunotherapy group was longer and the median has not yet been reached. The immunotherapy drugs did not help people with fewer tumor gene flaws. "What we're starting from is a regimen that's already better than chemo, though modestly, and then identifying patients who derive exceptional benefit".

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