“This is a major innovation, with known drugs, already used by oncologists, enthuses Professor Nicolas Girard, oncologist and pulmonologist at the Institut Curie, the risk of relapse and death is almost halved.”
Monday, April 11, during a plenary session of an international medical cancer congress (AACR), in New Orleans, this doctor specializing in lung cancer, at the head ofe the Institut du thorax Curie Montsouris, presented the results of an international phase 3 study conducted in patients with lung cancer localized and operable “non-small cell” type, therefore non-metastatic (no cancerous cell has migrated out of the lung).
Of the two main types of lung cancer, non-small cell lung cancer is the most common: it accounts for up to 84% of diagnoses, the majority of which (about 60%) are non-metastatic. In these patients, surgery is proposed to eliminate the tumour, but 30% to 55% of them recur or even die within 5 years, especially when the tumor is large. The search for therapeutic options with treatments to be taken before (neo-adjuvant) or after (adjuvant) surgery is therefore essential to improve the management of patients in the long term.
“While surgery is effective for people with non-small cell lung cancer, many of them recur, deplores Professor Nicolas Girard. Now, with this treatment neo-adjuvant combining immunotherapy with chemotherapy, we considerably reduce this risk of relapse and improve patient survival”.
A reduction of nearly 40% in recurrences
Proof of its therapeutic interest for patients, this treatment has already been approved by the American Medicines Agency, the FDA following the good results obtained by the phase 3 study (CheckMate-816) conducted since 2017 by Institut Curie teams with 358 patients.
What are the conclusions of the study?When given before surgery, treatment combining immunotherapies and chemotherapy reduces the risk of disease recurrence by 37%. Patient survival is also improved, with a 43% reduction in the risk of death.
These first results, published in the medical journal New England Journal of Medicine,even show that, for 24% of patients who received this new therapeutic combination, no trace of cancerous cells can be seen in the tissues removed during surgery – compared to only 2% of patients who received chemotherapy alone.
The overall survival data are promising since at two years, 83% of patients treated with the combination of immunotherapy and chemotherapy before surgery were alive, compared to 71% for chemotherapy alone.
Additional benefit: the treatment, administered in three courses before surgery, is well tolerated by patients and side effects are reduced. In effect, “the treatment reducing the size of the tumour, it facilitates the surgical act and therefore reduces the risk of post-operative complications”, explained Professor Girard.
In France, this protocol is still under study, but early access could facilitate access to this treatment for all patients.
Worldwide, lung cancer is the leading cause of cancer death with about 1.8 million deaths in 2020. In France, it is the 3rd most common cancer and its incidence is rising sharply in women.
Source : Institut du Thorax Curie-Montsouris press conference, April 11, 2022.
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