Immunotherapy Drug Fights Early-Stage Lung Cancer

By Dennis Thompson
HealthDay reporter

THURSDAY, May 20, 2021 (HealthDay News) – An immunotherapy drug is the first to significantly reduce the risk of cancer recurrence or death in people with early-stage lung cancer, researchers report.

Arezolizumab reduced the risk of disease recurrence or death by 34% in a certain group of people with stage II to IIIA non-small cell lung cancer – those whose tumors carry a protein that can help malignant cells escape detection by the immune system, according to the new findings.

In comparison, standard chemotherapy reduces the risk of cancer or future death by just 16%, according to the researchers.

Pending US Food and Drug Administration approval for this use, aezolizumab (Tecentriq) could become standard treatment for patients whose genetics interfere with the immune system’s ability to search for and kill cancer cells. said lead researcher Dr. Heather Wakelee, chief of oncology at Stanford. University medical center.

“It’s a deeper benefit than what we’ve seen with chemotherapy, and therefore, for me, it would be something that I wish I could offer my patients in that setting,” Wakelee said.

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This clinical trial “is the first time that we have seen effective immunotherapy in the treatment of early stage non-small cell lung cancer,” said Dr. Julie Gralow, medical director and executive vice president of ASCO. “This is an important advance in understanding the role of immunotherapy in early stage lung cancer, and potentially a step forward for many lung cancer patients.”

Lung cancer is the leading cancer killer in the United States, accounting for a quarter of all cancer deaths, according to the American Lung Association. Non-small cell lung cancer accounts for 4 out of 5 lung cancer cases.

Immune checkpoint inhibitors like arezolizumab work by suppressing the immune system’s brakes that are meant to prevent an immune response so strong that it starts attacking healthy cells in the body.

In this case, lung cancers are known to use a protein called PD-L1 to evade the immune system. About half of people diagnosed with early-stage lung cancer express PD-L1 on their tumor cells, the researchers said in briefing notes.

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The PD-L1 protein is generally only present in healthy cells; when white blood cells see the protein on a cancer cell, they take it as normal and do not attack. Arezolizumab blocks the signal sent by PD-L1, allowing immune cells to recognize and kill cancer.

The drug has already shown benefits in treating late stage lung cancer.

The new results will be presented at the virtual annual meeting of the American Society of Clinical Oncology.

For the study, researchers recruited 1,280 lung cancer patients whose tumors had been surgically removed and who had undergone chemotherapy. Half were randomly selected to receive aezolizumab, while the rest received supportive care.

Patients with stage II-IIIA non-small cell lung cancer with PD-L1 levels of 1% or greater in their tumors have responded well to aitzolizumab with reduced risk of recurrence or death. by 34% compared to the control group.

Among all patients with stage II-IIIA lung cancer, those who received arezolizumab had a 21% reduction in the risk of recurrence or death.

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The results represent “the first global Phase III trial using an immune checkpoint inhibitor to show disease-free survival in early-stage non-small cell lung cancer,” Wakelee said.

However, the drug is harsh on the patients.

Almost 22% of patients experienced serious to life-threatening side effects, compared to 11.5% of people in the control group receiving supportive care. Almost 20% of patients had to stop taking aezolizumab because of side effects.

Wakelee said this drug represents an opportunity to save the lives of lung cancer patients, if their malignant tumors are detected in time.

“It’s important to stress that patients need screening for lung cancer at an early stage, when it is potentially curable,” Wakelee said. She added that biopsies and tests should be done to see if people carry immune markers like PD-L1 that would make them good candidates for immunotherapy.

The clinical trial was funded by the drug’s manufacturer, Roche. Results presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

More information

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The US National Cancer Institute has more information on immune checkpoint inhibitors.

SOURCES: Heather Wakelee, MD, chief, oncology, Stanford University Medical Center, Palo Alto, California; Julie Gralow, MD, medical director and executive vice president of the American Society of Clinical Oncology (ASCO); ASCO 2021 Annual Meeting, June 4-8, 2021

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