Lung cancer, an important step forward to reduce the risk of relapses in operated patients – breaking latest news

In early stage lung cancer immunotherapy, before and after surgery, added to chemotherapy reduces the risk of recurrencedisease progression and patient death. An important step towards the concrete possibility of recovery for people who are diagnosed a non-small cell lung cancer and that intended to change the current standard of treatment. Historically, more than half of patients with early stages of this malignancy relapse following surgery, while adding immunotherapy to chemotherapy (which is the current cure) 62.4% of patients live two years later without having developed events, compared to 40.6% underlines Frederick Cappuzzodirector of Medical Oncology 2 at the Istituto Nazionale Tumori Regina Elena in Rome, commenting on the data from the KEYNOTE-671 study presented during the annual meeting of the American Society of Clinical Oncology (Asco), held in Chicago.

I study

Over 80% of the 44 thousand new cases of lung cancer a non-small cell carcinoma, one of the most frequent and lethal in our country, is registered every year in Italy. KEYNOTE-671 a phase three study (the last before drug approval) that recruited 797 patients with operable non-small cell lung cancer, stages II, IIIA or IIIB. Participants were divided into two groups and randomly received the immunotherapy drug pembrolizumab plus chemotherapy before surgery, followed by post-operative pembrolizumab or placebo plus chemo before and placebo after. The results show that with immunotherapy the risk of recurrence, progression or death is significantly reduced by 42% compared to standard chemo alone. These outcomes are significant not only for patients and oncologists, but also for thoracic surgeons, given the need for new therapeutic options that can improve relapse-free survival – adds Cappuzzo -. Pre-operative chemo often leaves sufferers debilitated even before undergoing surgerywhile the chemo-immuno mix was effective in acting on the micro-metastases and did not affect the opportunity for a complete resection. The new strategy better tolerated by patientsdoes not affect their quality of life. Thus it becomes critical that all people with a diagnosis of non-small cell lung cancer receive a correct staging of their disease before undergoing the scalpel: In those who are candidates for the operation, recent CAT and PET, brain resonance and a careful evaluation of the mediastinum (the median space of the thoracic cavity, between the lungs, ndr), to decide which is the most suitable strategy to proceed with concludes the expert.

Confirmations for metastatic patients

Long-term results from another trial (CheckMate -9LA) indicate that the addition of immunotherapy to chemo also effective as first-line treatment in patients with metastatic non-small cell lung cancer. The more than 700 participating patients were followed up for a minimum of four years and the results indicate that the dual immunotherapy (with nivolumab plus ipilimumab), associated with two cycles of chemotherapy, continued to prolong overall survival better than chemotherapy alone (up to four cycles followed by optional maintenance care), with 21% of patients receiving the first option compared to 16% of patients receiving chemo alone. The combination remained valid also in those categories with a cancer that is particularly difficult to treat (with PD-L1 less than 1%, or with squamous histology) and for which new treatment options are needed.