The odds of survival can greatly improve for people with the most common type of lung cancer if they are given a new type of drug that activates the immune system, along with the usual chemotherapy, a major new study has shown.
The differences would likely have been more pronounced, but many patients in the chemotherapy group were given Keytruda or a similar drug once their disease progressed. Twice as many patients were alive without disease progression when they received pembrolizumab in addition to chemotherapy.
The findings, published in the the New England Journal of Medicine, were reported on Monday at the American Association for Cancer Research annual meeting in Chicago.
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. "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". In patients who received the combination treatment, 48 percent saw their tumors shrink considerably, compared with 19 percent who only received chemotherapy.
That's a big difference for such an advanced cancer, said Dr. Alice Shaw, a Massachusetts General Hospital lung cancer expert and one of the conference leaders.
Non-squamous lung cancer patients make up about 80% of all the non-small cell lung cancers, so that amounts to over 150,000 patients in the USA each year, said Gomez, who was not involved in the new study.
"Essentially we think about gene editing as a spell checking program that's on your Word program for a computer", Kmiec said.
"The Merck data is pretty much a home run", said Dr. Roy Herbst, chief of medical oncology at Yale Cancer Center, who was not involved in the study.
Stand Up To Cancer (SU2C) raises funds to accelerate the pace of research to get new therapies to patients quickly and save lives now.
Patients in this trial were given frontline pembrolizumab or placebo in combination with pemetrexed (Alimta) and either cisplatin or carboplatin.
KEYNOTE-189 was a double-blind, phase III trial that had accrued 616 patients with advanced or metastatic nonsquamous NSCLC, regardless of PD-L1 expression. Patients whose tumors had sensitizing EGFR mutations or ALK alterations were excluded.
Patients were randomized 2:1 to pembrolizumab plus chemotherapy or to placebo and the same chemotherapy.
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).
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 USA healthcare spending.
For non-squamous non-small cell lung cancer patients, median survival with chemotherapy alone is somewhere around 11 or 12 months, he said.
After a median follow-up of 10.5 months, those in the immunotherapy group were half as likely to die.