Two studies have found what appears to be a major breakthrough in the fight against lung cancer.
"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.
Keytruda was approved a year ago as an initial treatment with chemo for the most common form of advanced lung cancer, but doctors have been leery to use it because that was based on a small study that did not show whether it prolongs life.
Non-squamous lung cancer patients make up about 80% of all the non-small cell lung cancers, so that amounts to over 150,000 patients in the USA each year, said Gomez, who was not involved in the new study.
Immunotherapy works by harnessing the body's immune system to attack tumors.
The research could lead to new treatment regimens.. Keytruda and Opdivo each cost about $13,500 monthly per patient. "Bloomberg-Kimmel Institute researchers worked with investigators at Memorial Sloan Kettering to put our collective, creative ideas together testing new strategies for combining immunotherapy with standard-of-care surgical procedures for the benefit of our patients".
All of these immune therapy treatments worked for only about half of patients, but that's far better than chemo has done in the past.
He added, "The findings of this trial have now underpinned multiple larger trials to test this approach in six different cancer types; this represents true leverage of support from SU2C-CRI". The most common side effects were nausea, anemia and fatigue and in both groups about 65% of patients experienced severe side effects.
'We're not almost where we need to be yet, ' said Dr. Roy Herbst, a Yale Cancer Center lung expert who had no role in the studies.
Scientists who weren't involved in the study agreed that it was highly significant. "I only treat lung cancer and I've been doing that for about 20 years".
Historically, chemotherapy or chemoradiotherapy, is given to lung cancer patients to shrink a large, non-metastasized tumor, and in the past, immunotherapeutic agents have been administered after surgery with limited results. The immunotherapy drugs did not help people with fewer tumor gene flaws.
How much it ultimately will extend life isn't known - more than half in the Keytruda group are still alive; median survival was just over 11 months for the others. The estimated proportion of patients in the combination therapy group who were alive and whose disease had not gotten worse at a year was about 34 percent, about double the proportion for the chemo-only group.
"I think we were all surprised at the magnitude of benefit and how clear the difference was at an early analysis, and that we could tell there was an overall survival difference", Gandhi said, adding that there was "a lot of excitement" at the conference about her study and several others involving immunotherapy.