New treatment saves patients from pain of chemotherapy

Immunotherapy could soon replace chemotherapy as the primary treatment for lung cancer, possibly revolutionizing 30 years of practice in treating the dreaded disease.

A recent clinical trial, known as Keynote-024 (KN-024), showed that immunotherapy is superior to chemotherapy in previously untreated patients with non- small cell lung cancer ( NSCLC). Progression-free survival was the trial’s primary goal, while overall survival was second. Immunotherapy achieved both.

Immunotherapy is a class of drugs that enables the immune system to fight cancer. The immune system’s T- cells normally attack harmful cells and viruses. When they interact with cancer, a protein called the Programmed Death-Ligand 1 (PD-L1) in the tumor deactivates the T-cells. Immunotherapy blocks this protein so T-cells can detect and destroy tumors.

“We believe that the Keynote- 024 results have the potential to change the therapeutic paradigm in first-line treat- ment of non-small cell lung cancer,” said Dr. Roger M. Perlmutter, president of MSD Research Laboratories, the company behind the study. “We look forward to sharing these data with the medical community and with regulatory authorities around the world.”

The Philippine Food and Drug Administration (FDA) approved immunotherapy for the treatment of advanced melanoma and PD- L1- positive lung cancer that had failed previous therapies.

According to the 2012 GLOBOCAN report of the International Agency for Research on Cancer (IARC), lung cancer is the top cause of cancer mortality worldwide, accounting for 1.5 million deaths annually. In the Philippines, doctors report over 12,000 new cases and more than 10,000 deaths each year.

KN-024 is a randomized study comparing immunotherapy and chemotherapy in 305 participants. When results demonstrated immunotherapy’s efficacy in halting cancer progress and improving patient survival, an independent Data Monitoring Committee (DMC) recommended an end to the trial, which was due to end in 2017. The DMC further advised that trial participants on chemo should switch to immunotherapy.

The results echoed previous findings that showed immunotherapy was safer than chemotherapy. Common reactions to immunotherapy include rash, cough, and decreased appetite, which are easier to manage compared to chemotherapy’s side effects.

The complete results of the KN-024 trial will be presented in an upcoming medical meeting.

Patients on chemotherapy often refuse additional cycles of chemotherapy because patients have a hard time tolerating these side effects. Anemia, diarrhea, alopecia, nausea, vomiting, and changes on the nails and skin are among the most common side effects of chemotherapy.

Patient response to chemotherapy also tends to reach a plateau after a certain amount of time on medication.

Aside from these side effects, maintenance chemotherapy is associated with increased medical costs.