“For the first time we see that immunotherapy is effective when used in the treatment of early stage lung cancer.” This is how Julie R. Gralow, medical director and vice president of the American Association of Medical Oncology (Asco) commented on the presentation of the results of the Impower010 study on the eve of the annual congress that will also be held in virtual mode this year. The study, which will be presented at the congress, evaluated the action of atezolizumab, a molecule that affects the PD-L1 checkpoint, in patients with early-stage non-small cell lung cancer after surgery. According to experts, these results open the door to the possibility of delaying the return of the disease in this category of patients who on average have a recurrence in 50% of cases.
I study
The trial, which involved nearly 1300 patients, showed that atezolizumab is also effective in the so-called adjuvant setting, after having already shown it to be in advanced cancer. The idea is to lengthen the time of disease recurrence after the patient has undergone resection of the tumor. The results show that in patients with stage II-IIIA disease and PD-L1 protein levels of at least 1%, this immunotherapy is effective and reduces the risk of relapse by 34%. The study was conducted by comparing atezolizumab with the best supportive treatment available. Even considering all enrolled patients, including therefore also those with PD-L1 levels lower than 1%, there is still a 21% reduction in the risk of relapse and an extension of survival from 35.3 months to 42.3 months. disease free. Treatment with immunotherapy caused a greater number of adverse events and approximately 20% of the sample gave up continuing the study.
Current treatments
Platinum-based adjuvant chemotherapy is currently standard care for patients with early stage fully resected cancer who are at high risk of recurrence or relapse. A therapy that guarantees a modest 4-5% improvement in 5-year survival. “Although surgery can cure some patients with early-stage lung cancer, recurrences of disease are very common. Prior to this trial, the only treatment known to help reduce the risk was chemotherapy or osimertinib for patients with the EGFR mutation, a small group, ”said Heather Wakelee, head of the Oncology Division of the University of Medicine. ‘Stanford University. “These data demonstrate that personalized medicine with atezolizumab reduces the chance of non-small cell tumor recurrence in patients with tumor expressing the PD-L1 biomarker.”
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