Immunotherapy shows lung cancer promise

Immunotherapies impress in key lung cancer trials

Doctors have found new ways to use some immune-boosting drugs to fight lung cancer.

"What it suggests is that chemotherapy alone is no longer a standard of care", said Dr. Leena Gandhi, a leader of the study and director of the Thoracic Medical Oncology Program at the Perlmutter Cancer Center at New York University Langone Health.

Combining an immunotherapy drug with chemotherapy almost doubled the survival time of some lung cancer patients compared to patients treated with chemotherapy alone, new research published Monday in the New England Journal of Medicine showed.

In the study, Merck's Keytruda, given with standard chemotherapy, cut in half the risk of dying or having the cancer worsen, compared to chemo alone after almost one year. Similarly, the new drug known as checkpoint inhibitors allows the immune system of the patient in order to destroy the deadly cancerous cells.

Hellmann's study, called CheckMate 227, found that advanced tumors that contain a lot of genetic mutations - often from smoking - respond particularly well to a combination of two immune therapy drugs, Yervoy and Opdivo, both from Bristol-Myers Squibb.

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In the study, Merck's Keytruda, given with standard chemotherapy, cut in half the risk of dying or having the cancer worsen.

Rates of serious side effects were similar, but twice as many in the Keytruda group dropped out because of them.

The estimated survival after a year was 69 per cent in those taking the immunotherapy drugs compared to 49 per cent who only had chemotherapy.

Dr. Jorge Gomez, a volunteer spokesperson for the American Lung Association and a medical oncologist and director of thoracic oncology at Mount Sinai Hospital in NY, explained that "about 220,000 patients are diagnosed with lung cancer a year in the USA". The immunotherapy drugs did not help people with fewer tumor gene flaws. Roughly 20% of patients see their tumors respond when they get chemotherapy before surgery; in this study, among patients who received Opdivo instead, 45% of tumors had regressed and in three patients there was no remaining tumor at all, Forde said. It is also possible, he said, that chemotherapy may kill some immune cells that interfere with the cancer-killing action of other parts of the immune system. The drugs are given through IVs and cost about $12,500 a month. 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.

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