Lung cancer survival improves with immunotherapy, according to studies

Research suggests that many more lung cancer patients may benefit from treatments that boost the immune system

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.

"A new cancer treatment can help some lung cancer tumors "[melt] away", seriously prolonging patients' lives, according to a series of breakthrough studies revealed this week.

In both studies, the positive results were not dependent on cancer cell's levels of PD-L1, a marker of inflammation that has been commonly used with drugs like Keytruda and Opdivo to help predict patient responses, with higher PD-L1 levels believed to lead to greater efficacy.

After 10.5 months, 69 percent of patients treated with the immunotherapy and chemotherapy combo were still alive, compared to 49 percent of patients who received chemotherapy with the placebo.

Many patients are diagnosed after the disease has spread. "That's tremendous progress for patients with lung cancer". Of the two types of lung cancer, small cell lung cancer is less common than non-small cell lung cancer, which affects up to 85% of all lung cancer patients.

Merck MRK announced encouraging data from a phase III study, EORTC1325/KEYNOTE-054, evaluating its anti-PD-1 therapy, Keytruda, in high-risk stage III melanoma patients in the adjuvant setting. "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", lead study investigator Leena Gandhi, MD, told CNN. The studies were sponsored by the drugmakers, and many study leaders and Herbst consult for the companies. Data from the study demonstrated that as an adjuvant treatment, Keytruda significantly increased recurrence free survival ("RFS") after surgery compared to placebo in such patients.

News coverage hailing new cancer therapies should always include details such as side effects and price - particularly when they will potentially add billions of dollars to annual US healthcare spending.

"We were all waiting to see a definitive Phase III study that showed very clear cut results", said Dr. Leena Gandhi, the study's primary investigator and director of thoracic medical oncology at NYU Langone in NY.

"What we look at in these trials is overall survival - how long patients live - and we look at a number called the median survival - how long 50% of patients live", said Gomez.

For patients with PD-L1-low tumors, defined as those with expression between 1% and 50% (n = 140), median PFS was 9.7 months for those assigned atezolizumab and 6.9 months for those assigned the control regimen (HR = 0.57; 95% CI, 0.38-0.84).

For non-squamous non-small cell lung cancer patients, median survival with chemotherapy alone is somewhere around 11 or 12 months, he said. "This is really a pivotal study. a new standard of care", said Shaw, who has no ties to the drugmakers. In that group, survival without worsening of disease was 43 percent after one year for those on the immunotherapy drugs versus 13 percent of those on chemo. "I only treat lung cancer and I've been doing that for about 20 years".

"We have a tool that helps us determine who are the patients that are most likely to benefit from this combination", Hellmann said.



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