The development of immune checkpoint inhibitors and the subsequent approval of Keytruda and Optdivo to treat advanced lung cancer has already given a huge boon to thousands of patients across the US every year. Now a new study, LCMC3, to be discussed in depth at this year’s meeting of the American Society of Clinical Oncology, suggests that drugs like this could give benefit to thousands more.
A phase II clinical trial conducted by the Lung Cancer Mutation Consortium, an organization coordinated by the Lung Cancer Research Foundation, found that giving artezolizumab (brand name Tecentriq) to patients with operable non small cell lung cancer (NSCLC) before surgery could also be extremely beneficial. Of the first 101 patients in the trial, 90 had surgery after being treated with artezolizumab. Of these patients, 15 had a major pathologic response to the treatment, defined as 10 percent or fewer viable cancer cells being found in the tumor tissue that was removed. Four patients had a complete response, meaning that there was a complete absence of residual cancer after the treatment, seventy two had stable disease, and four saw their disease progress.
Read More"Immune checkpoint therapy is now standard of care for patients with advanced (metastatic) lung cancer, and this study suggests that it may also have benefit in early stage, operable lung cancer" said the study's lead author, David Kwiatkowski, MD, PhD, senior physician at Dana-Farber/Brigham and Women's Cancer Center.
Surgery remains the only potentially curative treatment for early stage NSCLC patients, and is effective in nearly half of cases. However, there are also many patients who won't achieve a cure following surgery, and around 30 percent to 55 percent of patients with NSCLC will develop a recurrence. It's that proportion of patients, whose cancer comes back after surgery, that the LCMC3 trial is targeting. Whilst stressing that it's still early days, Dr Kris thinks that the results of this trial indicate that the approximately 50 percent of lung cancer patients currently cured by surgery could rise to up to 70 percent with the addition of targeted therapies and immune checkpoint inhibitors like artezolizumab given before main treatment.
While this is encouraging, there is still a long way to go before anything can be said for certain, but it does look like immune checkpoint inhibitors could well give even more benefit to lung cancer patients if given upfront. It's a strategy already being employed in the treatment of breast cancer, Dr Kris notes, although, he cautions, "This is a step towards cure, rather than a full cure."
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