Lung cancer, new treatment slows the disease in patients with a rare genetic mutation – breaking latest news

Il lung cancer remains a “hard nut” to deal with also because, since it does not give clear symptoms at the outset, more than 70% of patients arrive at the diagnosis when the tumor is already in an advanced stage and inevitably more difficult to cure. In recent years, however, scientific research has made important progress: they have been discovered different genetic mutations responsible for the disease and, consequently, developed differently new drugs able to block or slow its advance with the result of making patients gain months and even years of life. Just for sufferers with a rare form of non-small cell lung cancer, linked to a specific and uncommon alteration of the DNAhas also recently been approved by the Italian Medicines Agency (Aifa) a new molecule which can be prescribed to people who have advanced stage cancer and are not getting results from chemotherapy.

A rare and “aggressive” mutation

Amivantamab is a fully human bispecific antibody and is reimbursed by the NHS for adult patients with advanced lung cancer, with epidermal growth factor receptor (EGFR) activating exon 20 insertion mutations, after failure of platinum-based chemotherapy. “Patients with this specific subtype of cancer have few therapeutic options available, not only in number but also in effectiveness,” he explains. Filippo de Marinis, director of the Division of Thoracic Oncology and deputy director of the Lung Cancer Program at the European Institute of Oncology in Milan —. Just think that only 8% of people with this mutation survive five years after diagnosis». Are approximately 41 thousand new cases of lung cancer diagnosed every year in Italy and about 15% (more or less six thousand people in all) have an EGFR mutation. In 10% of cases, the EGFR mutation is an insertion in exon 20: a group of uncommon mutations on a protein that causes cells to grow rapidly, and as a result, helps cancer spread and proliferate. For this subgroup of patients, approximately 600, the risk of progression of the neoplasm is very high: «We are talking about a 93% greater risk compared to the most common EGFR mutations – continues de Marinis -. In this context, the arrival of amivantamab in Italy is an important milestone because it represents the first specific therapy for those suffering from this type of lung cancer. In addition, clinical trials conducted with this drug have shown a superiority over standard therapies in terms of efficacymaking it possible to double the life expectancy of patients”.

An exam makes the difference

Investigating whether and which genetic alterations are present within each patient’s tumor is therefore a fundamental step: “It is information that can make a big difference – he underlines Silvia Novelloprofessor of medical oncology at the Department of Oncology of the University of Turin and head of the Thoracic Oncology Structure at the San Luigi Gonzaga in Orbassano —: it is also on the basis of any DNA mutations, in fact, that for many types of cancer today the therapy is decided. Oncologists opt for a drug or a combination of medicines precisely on the basis of the so-called “molecular profile” of the neoplasm. In short, genetic tests, especially Next-Generation Sequencing (NGS), are a key tool not only for a correct diagnosis, but also for a personalized approach to cancer therapy, obviously including those in the lungs with EGFR exon 20 insertion mutations». The studies that led to the approval of amivantamab have shown median progression-free survival of patients (i.e. the time spent without the tumor advancing) of just over 8 months and an average overall survival of almost 23 months.

Slow down the neoplasm

“About 75% of patients with non-small cell lung cancer are in stage three or four (the most advanced) at the time of diagnosis, when metastases are already present,” continues Novello, who is also president of Women against lung cancer in Europe. (Walce) —. Unfortunately, in fact, disease symptoms are non-specific: cough, fatigue, chest pain, dyspnea, weight loss. Also for this reason it is important that the people most at risk of getting sick, i.e. current or former heavy smokers, undergo the spiral CT screening test which is now available free of charge in many Centers and quit smoking as soon as possible». In patients with advanced cancer, slowing down the evolution of the disease and gaining time with a good quality of life are the goals that can be achieved today. «The new therapy represents hope for all those who suffer from this type of lung cancer, both in terms of lengthening of life expectancyboth of quality improvement – he concludes Bruno Aratri, president of the IPOP Association (Together for Pulmonary Oncology Patients) —. We hope that these innovative treatments, increasingly targeted and effective, will be made available quickly and equally guaranteed throughout the national territory to patients who need it.