Studies find new ways to use immune-boosting lung cancer drugs

Research suggests that many more lung cancer patients may benefit from treatments that boost the immune system

It's called immunotherapy. Doctors have been using Keytruda and Opdivo for several years treating lung cancer. It's the biggest win so far for immunotherapy, which has had much of its success until now in less common cancers. Researchers at New York University found adding Keytruda to chemotherapy doubled overall survival of patients with non-small cell lung cancer; the most common type of the disease.

Doctors have found new ways to use some immune-boosting drugs to fight lung cancer.

Another study found that an immunotherapy combo - the Bristol-Myers Squibb drugs Opdivo and Yervoy - worked better than chemo for delaying the time until cancer worsened in advanced lung cancer patients whose tumors have many gene flaws, as almost half do. That combo could soon become a routine treatment.

"It's a big deal", Dr. Roy Herbst, head of medical oncology at the Yale Cancer Center, told Shots.

Pembrolizumab, sold under the brand name Keytruda, is an FDA-approved drug sold by a subsidiary of Merck & Company, Inc. that sponsored this study.

But the benefits for Opdivo and Yervoy lasted less than two months on average.

Immunotherapy works by harnessing the body's immune system to attack tumors. The drugs are given through IVs and cost about $12,500 a month.

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Of the two types of lung cancer, small cell lung cancer is less common than non-small cell lung cancer, which affects up to 85% of all lung cancer patients. A physician and researcher from the Moffitt Cancer Center in Tampa, Dr. Jhanelle Gray was involved and is an author of the study. In it, 616 patients were given chemo and some also received Keytruda. Keytruda is also used to treat melanoma, Hodgkin lymphoma, and cancers of the stomach, head, neck and bladder.

The estimated survival after a year was 69 per cent in those taking the immunotherapy drugs compared to 49 per cent who only had chemotherapy. 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.”. "This is really a pivotal study. a new standard of care", said Shaw, who has no ties to the drugmakers.

"The data show that treatment with pembrolizumab and chemotherapy together is more effective than chemotherapy alone", said lead investigator Leena Gandhi, director of the thoracic medical oncology program at Perlmutter Cancer Center at NYU Langone Health.

Some patients with non-small cell lung cancer respond to drugs that target specific mutations.

Of 679 patients, 299 had a high number of gene flaws in their tumors. And it suggests that it's fruitful to combine immunotherapy treatment with chemotherapy. 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. "We have patients on these immunotherapies alive more than eight years".

The median time until cancer worsened was about 7 months on the immunotherapy drugs versus 5.5 months for chemo. And among those in the comparison group, who got a placebo and chemotherapy, 99 percent reported side effects.

Another rival, Genentech, recently announced that its checkpoint inhibitor, Tecentriq, improved survival in a study similar to the one testing Keytruda.

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