Promising Hope For Lung Cancer Patients

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Combining an immunotherapy drug with chemotherapy almost doubled the survival time of some lung cancer patients compared to patients treated with chemotherapy alone, new research published Monday in the New England Journal of Medicine showed. The studies simultaneously were published by the New England Journal of Medicine on a day that some experts called the “Super Bowl of lung cancer immunotherapy.”.

The findings represent another step forward for immunotherapy, which has been making steady gains against a number of different cancers.

Unlike traditional treatment, immunotherapies encourage the body's natural defences to target and destroy cancer cells, new research has revealed.

Recalling a patient with advanced lung cancer whose tumor disappeared and has not grown back after finishing treatment 24 months ago, Gomez said, "I'm now becoming much more optimistic that if we can really find a way to ideal this treatment and to really figure out who are the patients who do the best and why that we may be able to do something like get rid of lung cancer for at least some patients".

"If you want to see long-term survival, you've got to give immunotherapy as soon as possible", Herbst said. And it suggests that it's fruitful to combine immunotherapy treatment with chemotherapy. "We have patients on these immunotherapies alive more than eight years".

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"However, these initial results are highly encouraging and we believe will spur interest in further neoadjuvant clinical trials across additional cancers", added Dream Team Investigator Patrick Forde, MBBCh, assistant professor of oncology at Bloomberg-Kimmel Institute for Cancer Immunotherapy, who led the study and served as co-principal investigator of the clinical trial along with Jamie Chaft, MD of Memorial Sloan Kettering.

The patients experienced a significantly longer period during which their disease did not worsen, compared with people who received only chemotherapy, said Memorial Sloan Kettering Cancer Center oncologist Matthew Hellman, who led the study.

In the study of 616 patients, pembrolizumab (Merck's Keytruda) combined with standard chemotherapy halved the risk of death or having the cancer compared to chemo alone after almost one year. While that's a notable difference, the drug did not stop cancer entirely in most patients.

Other studies in lung cancer have involved another checkpoint inhibitor, nivolumab, or Opdivo (made by Bristol-Myers Squibb), which works in a similar way to pembrolizumab. By killing some tumor cells, chemotherapy could pop open the bags, release the contents and help immune cells - unleashed by the checkpoint drugs - to identify their prey. Herbst compares it with inflammation around a cut, which marshals the immune system into action, only in this case the wound being targeted is debris from dead cancer cells. That means that the tumors removed in surgery had at least 10 percent fewer cancer cells than they did before treatment. They were picked at random to receive either chemotherapy plus immunotherapy, or chemotherapy plus a placebo, with two-thirds receiving the combination that included immunotherapy. But Merck, the company that makes it, wanted to find out how the drug works in patients who aren't obvious candidates as determined by that blood test.

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. "Going forward, it will only get better". The drug alone is already approved to treat patients with high levels of those markers. However, as in the latest study, the effects frequently don't persist for most patients. Those with high levels of the marker fared somewhat better with immunotherapy than those with low levels - but even those with low levels were helped. "We're making progress, but still only benefiting 30 to 40 percent of patients". Still, he said, the approach was not a cure and there is a lot of room for improvement. By merging our resources in this way, we had the capacity to optimize results right out of the starting block."With the success of this trial, several new, expanded studies are already underway".

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