Published: Tue, April 17, 2018
Medicine | By Earnest Bishop

New studies show hope for turning immune system against lung cancer

New studies show hope for turning immune system against lung cancer

But trials over the last five years have repeatedly shown more uses for immune therapy in lung cancer, and the new research confirms that almost all lung cancer patients will now receive immune therapy, said Patrick Forde, the first author on one of the studies and a lung cancer specialist at Johns Hopkins Medical.

"What it suggests is that chemotherapy alone is no longer a standard of care", said Dr. Leena Gandhi, a leader of the study and director of the Thoracic Medical Oncology Program at the Perlmutter Cancer Center at New York University Langone Health.

The study results apply only to patients whose lung cancer does not begin in the squamous cells (or surface lung cell layer) and who also lack certain genetic mutations. He said that tumor cells were like bags of hidden proteins that, if exposed, the immune system could use as targets to find and attack cancer.

"It's pretty fantastic times to have so many positive studies at once", added Matthew Hellmann, a lung cancer specialist at Memorial Sloan Kettering Cancer Center, who led one of the studies. Yet, median survival among the study participants who received both immunotherapy and chemo has not yet been reached. It's called immunotherapy. Doctors have been using Keytruda and Opdivo for several years treating lung cancer.

They cost more than $100,000 a year, can have serious side effects and help only some patients, generally fewer than half.

"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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"We're not almost where we need to be yet", said Dr. Roy Herbst, a Yale Cancer Center lung expert who had no role in the studies.

"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. "I only treat lung cancer and I've been doing that for about 20 years". It is also possible, he said, that chemotherapy may kill some immune cells that interfere with the cancer-killing action of other parts of the immune system.

The estimated survival at 12 months was 69.2 percent in the group that received immunotherapy, and 49.4 percent in those who did not.

The study, a phase III clinical trial testing treatment effectiveness and side effects, included 616 patients at 118 medical facilities around the globe.

How much it ultimately will extend life isn't known - more than half in the Keytruda group are still alive; median survival was just over 11 months for the others.

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