Immune therapy key to extending lung cancer patients' lives

Stefanie Joho 27 in Penn Valley Pa. last spring was treated with Merck’s Keytruda for advanced colon cancer. A new study shows that the immunotherapy drug when combined with chemotherapy also prolongs survival in patients with advanced lung cance

Two studies have found what appears to be a major breakthrough in the fight against lung cancer. However, the SU2C-CRI Dream Team researchers hypothesized that leaving the tumor in place during initial treatment with immunotherapy would turn it into an "auto-vaccine" resulting in the activation of tumor-specific T cells that would then circulate through the body and find distant sites of micrometastases, thereby preventing relapse post-surgery which can happen to at least one-half of lung cancer patients who undergo surgery.

"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.

He added, "The findings of this trial have now underpinned multiple larger trials to test this approach in six different cancer types; this represents true leverage of support from SU2C-CRI".

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The immune therapy treatments worked for only about half of the patients in the study.

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 U.S.". Yet, median survival among the study participants who received both immunotherapy and chemo has not yet been reached. Worldwide, lung cancer causes 1.69 million deaths annually.

Immune therapy combined with chemo helped extend lung cancer patients' lives in clinical studies.

. Four such drugs, called checkpoint inhibitors, which unleash the patient's own immune system to kill malignant cells, have been approved so far. The chemotherapy was a drug called pemetrexed, plus either carboplatin or cisplatin.

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Chemotherapy may no longer be the standard cancer treatment after the publication of a series of studies by the American Association for Cancer Research in Chicago.

"If you want to see long-term survival, you've got to give immunotherapy as soon as possible", Herbst said.

Historically, chemotherapy or chemoradiotherapy, is given to lung cancer patients to shrink a large, non-metastasized tumor, and in the past, immunotherapeutic agents have been administered after surgery with limited results. SU2C is now funding four Cancer Interception teams focusing on lung and pancreatic cancer. The estimated proportion of patients in the combination therapy group who were alive and whose disease had not gotten worse at a year was about 34 percent, about double the proportion for the chemo-only group.

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Other studies in lung cancer have involved another checkpoint inhibitor, nivolumab, or Opdivo (made by Bristol-Myers Squibb), which works in a similar way to pembrolizumab.

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