New studies show hope for turning immune system against lung cancer

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In his own research, Hellmann said, his team finessed the dosing of the two drugs to minimize side effects, and found that the combination therapy was significantly better than chemotherapy alone against tumors with a lot of mutations.

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 U.S. each year, said Gomez, who was not involved in the new study.

Keytruda was approved past year 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.

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"Non-small cell lung cancer is actually the leading cause of cancer death in the world even though it's not the most common cancer", said Dr. Leena Gandhi, lead investigator of the study and director of the thoracic medical oncology program at Perlmutter Cancer Center at NYU Langone Health. "We have patients on these immunotherapies alive more than eight years".

Combining an immunotherapy drug with chemotherapy almost doubled the survival time of some lung cancer patients compared to patients treated with chemotherapy alone, new research published Monday in the New England Journal of Medicine showed.

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.

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Dr Roy Herbst, a lung cancer specialist at Yale Cancer Centre, who was not involved in the studies, said it could be the start of a fundamental change in treatment. The most common side effects were nausea, anemia and fatigue and in both groups about 65% of patients experienced severe side effects. In that group, survival without worsening of disease was 43 percent after one year for those on the immunotherapy drugs versus 13 percent of those on chemo. The drugs are given through IVs and cost about $12,500 a month. In it, 616 patients were given chemo and some also received Keytruda.

So-called tumor mutational burden can be measured with tests that are already routinely done in many cancer centers, Hellmann said, so they should be readily accessible. Four immunotherapy drugs for cancer, known as checkpoint inhibitors, have been approved. 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. Details are expected in a couple months.

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