Immune therapy key to extending lung cancer patients' lives

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But those drugs and rival immunotherapies from Roche and AstraZeneca are jockeying for pieces of the largest lung cancer market. However, it doesn't discuss side effects or conflicts of interest and - most significantly - doesn't tell us about the $150,000 annual price tag for each patient.

Combining standard chemotherapy with pembrolizumab was "superior in terms of response - keeping people alive without progression of their cancer - and improving the overall survival of patients with metastatic lung cancer compared to chemotherapy alone", Dr. Gandhi said. After one year, 68 percent of responders to Opdivo and Yervoy continued to benefit from the therapy.

"I've been treating lung cancer for 25 years now, and I've never seen such a big paradigm shift as we're seeing with immunotherapy", said Dr. Roy Herbst, chief of Medical Oncology at the Yale Cancer Center. The studies were sponsored by the drugmakers, and many study leaders and Herbst consult for the companies.

These immunotherapy drugs include a new class of treatment that have helped keep former President Jimmy Carter's melanoma from spreading.

Patients in the study had an advanced stage of non-squamous non-small-cell lung cancer.

Findings showed the Keytruda-pemetrexed-platinum chemotherapy combination significantly improved overall survival, reducing the risk of death by half compared with chemotherapy alone.

The Keytruda combo also delayed the time until cancer worsened - an average of nine months versus five months for the chemo-only group.

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Press briefing moderator Alice Shaw, MD, of Massachusetts General Hospital Cancer Center in Boston, said results did establish a new standard of care for untreated, advanced nonsquamous NSCLC.

Several other questions remain, including whether patients with high levels of PD-L1 expression on their tumor cells who have already been found to benefit from this type of immunotherapy reap any extra benefits from chemotherapy, Yau said.

Rates of serious side effects were similar, but twice as many in the Keytruda group dropped out because of them.

About 80 percent of lung cancer cases are attributed to smoking.

Immunotherapy can transform lung cancer treatments, giving patients hope for longer lives, doctors said on Monday. Medicare recently agreed to cover the $3,000 test for advanced cancers. PFS favored pembrolizumab across PD-L1 expression status and achieved statistical significance for patients with tumors that had intermediate or high PD-L1 expression. The estimated 12-month overall survival (OS) rate at a median follow-up of 10.5 monbths was 69.2% (95% CI, 64.1-73.8) in the pembrolizumab arm compared with 49.4% (95% CI, 42.1-56.2) in the control group (HR, 0.49; 95% CI, 0.38-0.64; P .001). By killing some tumor cells, chemotherapy could pop open the bags, release the contents and help immune cells - unleashed by the checkpoint drugs - to identify their prey. We do need to focus more on how to differentiate the patients who will get the most benefit. "The lifespan for people with lung cancer is not good and so improving three to six months is a major victory".

Regarding the need for PD-L1 testing and the efficacy across subgroups, Gandhi noted, "I think that for most of us in the field, we would be quite hesitant to give up on PD-L1, or some biomarker to select patients because clearly still not all patients are benefiting".

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