Immunotherapy Drug Helping Lung Cancer Patients
By Robert Preidt
THURSDAY, October 1, 2020 (HealthDay News) – Newly approved drug for the number one leading form of cancer killer, lung cancer, improves patient survival, a new study confirms.
The immunotherapy drug Tecentriq (atezolizumab) was approved earlier this year by the United States Food and Drug Administration to treat patients with newly diagnosed non-small cell lung cancer (NSCLC), which accounts for up to 85% of all lung tumors.
Tecentriq targets a protein known as PD-L1 which is found on the surface of tumor cells. Normally, this protein signals the body’s immune system T cells not to attack. However, by targeting PD-L1, Tecentriq releases the body’s natural T cells to target and destroy these cancer cells, researchers from the Yale Cancer Center explained.
Tecentriq “has already shown excellent activity in patients who progress to first-line chemotherapy, but this study confirmed that the drug is active in some patients who have not yet received treatment for lung cancer,” said said medical oncologist Dr Nagashree Seetharamu, who treats lung cancer patients, but was not involved in the new study. She practices at the Northwell Health Cancer Institute in Lake Success, NY
The new study was funded by Tecentriq maker Genentech, and the results were published on September 30 in the New England Journal of Medicine.
The study included 554 patients with metastatic stage 4 NSCLC tumors. All patients had tumors devoid of mutations in the EGFR or ALK genes: As the researchers explained in a press release from Yale, tumors with these mutations are best treated with other drugs.
Among 205 patients whose tumors exhibited high cellular expression of PD-L1, the median overall survival was 20 months for those who received Tecentriq compared to 13 months for those who received standard platinum-based chemotherapy.
Median progression-free survival – the time between treatment and the onset of disease worsening – was eight months for patients who received Tecentriq compared to five months for those on standard chemotherapy, the researchers found.
“These are exciting results that could be life changing for many patients,” said lead author of the study, Dr. Roy Herbst. He is the head of the medical oncology department at the Yale Cancer Center as well as at Smilow Cancer Hospital.
“Lung cancer is the most common cancer in the world, with over 1.5 million patients diagnosed each year. Half of patients are diagnosed with metastatic disease, and they could be a candidate for this drug,” Herbst said in the press release.
“The fact that [Tecentriq] was generally well tolerated, ”said Herbst, who is also associate director of the cancer center for translational research at the Yale Cancer Center in New Haven, Connecticut. Side effects for the patients were similar to those seen in other trials of the drug, which have been approved for the treatment of several types of cancer. “
The trial also evaluated the performance of Tecentriq in patients with a “high tumor mutational burden”, which means that they had high levels of genetic mutations in cancerous DNA fragments detected in blood tests. In some types of cancer, a high mutational burden is linked to better responses to immunotherapy drugs like Tecentriq.
“Of these patients with NSCLC, those with a high tumor mutational burden who received [Tecentriq] showed an improvement in progression-free survival of seven months compared to four months for those who received chemotherapy, ”Herbst said. [blood] biomarker needs to be further explored. “
For his part, Seetharamu noted that “there are many commercially available and experimental drugs that target PD-L1”. And she noted that the study had one flaw.
Tecentriq “has been compared to platinum-based chemotherapy alone, which is currently not the most common standard treatment,” Seetharamu pointed out. Instead, oncologists are increasingly using standard chemotherapy plus another type of immunotherapy drug, Keytruda. The new study, however, did not present a direct comparison between Tecentriq and Keytruda plus chemotherapy.
“It’s understandable,” Seetharamu said, “since the study began before these new treatments became standard clinical practice.”
Either way, she said, “the 20 month overall survival in selected patients with elevated PD-L1 expression treated with Tecentriq alone is impressive and may provide another non-chemotherapeutic treatment option for patients diagnosed with elevated PD-L1 lung cancer. “
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