Thursday, 13 December, 2018

Merck Immunotherapy Drug Shines In Lung Cancer Study

A combination of an immunotherapy drug from Merck and standard chemotherapy led to improved survival for cancer patients A combination of an immunotherapy drug from Merck and standard chemotherapy led to improved survival for cancer patients. Peter Dazeley Getty Images
Ben Pena | 17 April, 2018, 12:36

And it turns out that Keytruda, in combination with standard chemotherapy, also works in patients even if they have a low score on the blood test, which measures something called the tumor proportion score for PD-L1.

Chicago: For the first time, a treatment that boosts the immune system greatly improved survival in people newly diagnosed with the most common form of lung cancer. One group was treated only with chemo, while the other got an immunotherapy drug called Keytruda plus chemo.

Medical experts have already been using immunotherapy to treat different types of cancers.

Dr. Jorge Gomez, a volunteer spokesperson for the American Lung Association and a medical oncologist and director of thoracic oncology at Mount Sinai Hospital in NY, explained that "about 220,000 patients are diagnosed with lung cancer a year in the United States". 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.

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.

In the study, Merck's Keytruda, given with standard chemotherapy, cut in half the risk of dying or having the cancer worsen, compared to chemo alone after almost one year. Checkpoint inhibitors are one of two main types of immunotherapy. The drugs unleash the patients own immune system to kill malignant cells.

"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. And among those in the comparison group, who got a placebo and chemotherapy, 99 percent reported side effects.

Scientists who werent involved in the study agreed that it was highly significant.

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Lung cancer is the leading cause of cancer death globally, causing 1.7 million fatalities a year. He was at the American Association for Cancer Research meeting in Chicago where the results were announced, and was asked to provide commentary afterwards. The chemotherapy was a drug called pemetrexed, plus either carboplatin or cisplatin.

Other studies presented at the meeting also highlighted advances in immunotherapy against lung cancer, but were at earlier points in the research and less likely to bring about immediate changes in medical practice.

Gandhi said chemotherapy alone had only a "modest benefit", and could add only a few months of life, with most patients surviving about a year or less. But many doctors did not adopt it because the trial was small and didnt initially show a survival benefit, Gandhi said.

A year and a half after treatment, the disease had returned in three-quarters of patients with the new treatment.

And for those with neither a lot of mutations nor a lot of immune cells, chemotherapy plus Keytruda seems to be the best choice, he said. Their tumors lacked certain mutations that would have made them eligible for other, "targeted" treatments.

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 median time until cancer worsened was about 7 months on the immunotherapy drugs versus 5.5 months for chemo.

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