A team of scientists confirms that immunotherapy given at the early stage of lung cancer, and before surgery, reduces the size of the tumor to be removed, increases the number of immune cells in the tumor and reduces the number of relapses.
While research until then had mainly made progress on the treatment of advanced lung cancer, the results published in the New England Journal of Medicine have just changed the game. The team of scientists confirmed that immunotherapy given at the early stage of lung cancer, and before surgery, reduces the size of the tumor to be removed, increases the number of immune cells in the tumor, and reduces the number of relapses.
Nivolumab
We are talking about non-small cell lung cancer (NSCLC), which is the most common form of the disease. Immunotherapy is a rapidly growing therapeutic strategy that involves stimulating the patient’s immune system to recognize cancer cells and destroy them. When lung cancer is at “a stage accessible to surgery”, it is still at an early stage of the disease.
Until now, immunotherapy has been used to treat advanced forms of non-small cell lung cancer, and after surgery. But this new study proves that the administration of nivolumab, an anti-PD-1 immunotherapy administered before surgery (“adjuvant immunotherapy”) makes it possible to improve its performance and effectiveness in patients with lung cancer. at an early stage. In fact, these results completely change the way of approaching the treatment of lung cancer caught at a fairly early stage of the disease.
The researchers administered two doses of nivolumab (3 mg / kg of nivolumab intravenously every two weeks) before surgery to 20 patients with lung cancer accessible to surgery. All suffered from stage I, II or III non-small cell lung cancer, which was considered operable.
16 of the 20 patients are alive and without recurrence
Twenty patients were able to have a complete surgical resection of their tumor after receiving neoadjuvant immunotherapy. After surgery, 16 of the 20 patients are alive and without recurrence. A major immunological response is observed in 45% of the tumors removed and this treatment has never delayed or hampered the surgery. Three patients had a relapse of their lung cancer, 2 of whom had additional treatment and did not have a new relapse. One patient died of recurrent metastatic cancer approximately 16 months after surgical resection.
“We wanted to examine the tumor and the immune system of patients before treatment and examine them again after treatment to analyze the changes,” said Patrick Forde, lead author and lung cancer specialist at Johns Hopkins Bloomberg-Kimmel, Washington DC. “We observed tumor regression in almost half of these patients with early stage lung cancer and we did not expect to see such a major response with just two doses (of nivolumab).”
Lung cancer now affects women more
About 50% of patients with non-small cell lung cancer relapse after surgery. The prognosis for lung cancer remains poor, with a survival of 1 to 5 years equal to 15% all stages combined.
In the United States, in the Caucasian and Hispanic groups born since the mid-1960s, lung cancer now affects women more than men, traditionally however much more affected by this disease. In France, lung cancer ranks second in men and third in women among the most frequent tumors, with approximately 32,300 and 16,800 new cases per year, respectively.
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