Published Jun 1, 2020

New Hope For Lung Cancer Patients — FDA Approves Drug Combination Opdivo And Yervoy For First Course Treatment

A new drug combination has been approved by the FDA for the treatment of lung cancer. This marks a historic development in research, but an expert says there's still more to be done

Shelby Black

Details

Opdivo For Lung Cancer

Opdivo is a checkpoint inhibitor for the treatment of metastatic non-small cell lung cancer (NSCLC) patients
Checkpoint inhibitors are immunotherapy drugs which block proteins that can cause cancer to spread within the body
Opdivo was initially used for the treatment of late stage lung cancer, but now has been approved for early stage patients as well
Immunotherapy drugs can help increase survival rate

A new option for first course treatment is now available to lung cancer patients, pointing to a historic trend in recent Food and Drug Administration (FDA) cancer drug approvals over recent months.

Checkpoint inhibitor Opdivo (nivolumab) was approved by the FDA in 2018, but recently it’s also been approved in combination with drug Yervoy (ipilimumab) as a first-line treatment for metastatic non-small cell lung cancer (NSCLC) patients with the PD-L1 protein. Checkpoint inhibitors are man-made immunotherapy drugs that shut down key proteins on immune cells such as PD-L1, which if active, helps cancer spread across the body. By blocking these proteins, it slows the growth of cancer within the body and can improve survival rate. Opdivo was initially used for the treatment of late stage lung cancer, but now has been approved for early stage patients as well.

Over the years, lung cancer treatment has changed tremendously with checkpoint inhibitors. However, in order for this drug to work, one must have an expression of protein PD-L1, which not every patient has.

“These new checkpoint inhibitors are promising, but they are not the magic bullet we are searching for,” Dr. Raja Flores, Chairman for the Department of Thoracic Surgery at Mount Sinai Health System, tells SurvivorNet. “They can prolong survival to some extent in certain patients whose tumors express PD-L1, but they are not a cure. We are still learning about these drugs and the tumor microenvironment.”

While Dr. Flores notes this combination approval is an important step in lung cancer treatment, he notes that surgery and routine screenings have proven to be the most effective treatment options for those battling lung cancer.

“Currently surgery is the only reliable way to achieve cure in patients with early stage disease,” Dr. Flores explains. “The only way to increase the number of patients identified at early stages when surgery can make a difference is through screening. Lung cancer screening is the only real proven way to decrease lung cancer mortality in the population.”

Dr. Geoffrey Oxnard explains how checkpoint inhibitors work for lung cancer

Checkpoint inhibitors have been proven effective for certain later-stage cancers, but the genetic codes in certain people may inhibit their positive effects. In order to know if you're a viable candidate for checkpoint inhibitors as a treatment for your later stage cancer, check with your doctor.

One of Opdivo’s main competitors is Keytruda, a first course of treatment for squamous cell non-small cell lung cancer (NSCLC) that has spread into the body, when combined with chemotherapy.

What Is NSCLC?

NSCLC is the most common form of lung cancer, with up to 85 percent of lung cancers being NSCLC. The disease is when malignant cancer cells form in the tissues of the lung, and squamous cell carcinoma, adenocarcinoma and large cell carcinoma are all subtypes of NSCLC. Adenocarcinoma is predominantly found in current or former smokers. Treatment options for this type of lung cancer have included surgery, postoperative chemotherapy, and radiation. Now, with the approval of Opdivo, survival rates are even more promising during treatment.

The Immunotherapy Revolution For Lung Cancer

Immunotherapy harnesses the power of a person's own immune system to recognize and kill cancer cells, and it’s been a game-changer in lung cancer treatment. Immunotherapy was initially used as a treatment option only for advanced lung cancer patients, but now studies have started in trying to treat early stage lung cancer with immunotherapy.

Dr. Brendon Stiles says immunotherapy has changed the face of lung cancer treatment

Today, many clinical trials may combine immunotherapy agents. The hope is that tweaking the immune system in more than one way will awaken it so that it recognizes and attacks cancer cells. Many trials combine immunotherapy drugs and chemotherapy in cases where chemotherapy alone did not have good outcomes.

Despite immense success many immunotherapy drugs have shown, this treatment option is not right for everyone. Your oncologist can help you determine if immunotherapy may be beneficial for you, and considerations include the molecular characteristics of your tumor and the therapies you have tried in the past as well as your overall health.

Dr. Leena Gandhi explains whether immunotherapy is the right treatment option for you

Learn more about SurvivorNet's rigorous medical review process.

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