Immuno-Chemotherapy Combo Extends Lung Cancer Victim's Survival Period

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"Today is a big day in lung cancer", Forde said.

In the study of 616 patients, pembrolizumab (Merck's Keytruda) combined with standard chemotherapy halved the risk of death or having the cancer compared to chemo alone after almost one year.

The results are expected to quickly set a new standard of care for about 70,000 patients each year in the United States whose lung cancer has already spread by the time it's found.

At one year, 43% percent of patients on the combination therapy had not seen any progression of their cancer, compared to 13% of those with chemotherapy.

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.

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

Chemotherapy may no longer be the standard cancer treatment after the publication of a series of studies by the American Association for Cancer Research in Chicago. Similarly, the new drug known as checkpoint inhibitors allows the immune system of the patient in order to destroy the deadly cancerous cells. The drugs are given through IVs and cost about $12,500 a month.

In a second study, doctors found that giving Opdivo to advanced lung cancer patients before surgery helped shrink tumors and kill cancer cells.

"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.

After a median follow-up time of 10.5 months, Gandhi said, the patients in the combination group were 51 percent less likely to die, compared with patients in the chemo-only arm. Keytruda is also used to treat melanoma, Hodgkin lymphoma, and cancers of the stomach, head, neck and bladder. More research is needed to know if the combo improves overall survival, as Keytruda did.

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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. According to the recently obtained finings, the medical experts suggest a new way to be used in treating lung cancer. And he said the trial showed that “tumor mutational burden” is a reliable way to predict who will benefit from the medications. The most common side effects were nausea, anemia and fatigue and in both groups about 65% of patients experienced severe side effects.

Dr. Matthew Hellmann of Memorial Sloan Kettering Cancer Center in NY led a study testing the Opdivo-Yervoy combo versus chemo in a slightly different group of newly diagnosed advanced lung cancer patients.

Of 679 patients, 299 had a high number of gene flaws in their tumors. One group was treated only with chemo, while the other got an immunotherapy drug called Keytruda plus chemo. 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 are alive more than eight years".

Other companies have similar immunotherapy drugs, but Merck's product has an advantage for treatment of lung cancer because it already has data in hand to show its drug is effective in this setting.

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