Im­munother­apy drug helps fight lung can­cer

The Columbus Dispatch - - Front Page - By Denise Grady

The odds of sur­vival can greatly im­prove for peo­ple with the most com­mon type of lung can­cer if, along with the usual chemo­ther­apy, they are also given a drug that ac­ti­vates the im­mune sys­tem, a ma­jor new study has shown.

The find­ings should change med­i­cal prac­tice im­me­di­ately, can­cer ex­perts say: Pa­tients with this type of lung can­cer should re­ceive an im­mune-ac­ti­vat­ing drug, also called im­munother­apy, as early as pos­si­ble af­ter the di­ag­no­sis is made.

“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 find­ings rep­re­sent an­other step for­ward for im­munother­apy. Four im­munother­apy drugs for can­cer, known as check­point in­hibitors, have been ap­proved. The drugs un­leash the pa­tient’s im­mune sys­tem to kill ma­lig­nant cells.

They cost more than $100,000 a year, can have se­ri­ous side ef­fects and help only some pa­tients, gen­er­ally fewer than half. But when the drugs work, re­sponses can be long-last­ing, and re­searchers are rush­ing to find ways to com­bine treat­ments to im­prove their ef­fects.

“I’ve been treat­ing lung can­cer for 25 years now, and I’ve never seen such a big par­a­digm shift as we’re see­ing with im­munother­apy,” said Dr. Roy Herbst, chief of med­i­cal on­col­ogy at the Yale Can­cer Cen­ter. He was not in­volved in the study.

Pa­tients in the study had an ad­vanced stage of non-squa­mous, non-small-cell lung can­cer. The im­mune-ac­ti­vat­ing drug was a check­point in­hibitor called pem­brolizumab, or Keytruda, made by Merck, which paid for the study. The chemo­ther­apy was a drug called peme­trexed, plus ei­ther car­bo­platin or cis­platin.

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. The com­bi­na­tion treat­ment is a sig­nif­i­cant im­prove­ment, she said. It is al­ready ap­proved as a first­line treat­ment for this dis­ease, so it should be cov­ered by health in­sur­ers.

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