This year again, important announcements were made during the ASCO International Cancer Congress. We return to those which concern lung cancer treatments.
New standard of treatment for small cell lung cancer
Recently publicized by Florent Pagny, small cell lung cancer (SCLCC) affects around 500 people each year in France. Particularly aggressive, he had not experienced any therapeutic advances for 30 years: “ The current standard treatment consists of giving radiotherapy and chemotherapy concomitantly”recalls Professor Nicolas Girard, pulmonologist and head of the medical oncology department at the Institut Curie.
The study ADRIATIC finally changes the situation. In this study, a immunotherapy anti-PL1, the durvalumab (Imfinzi©), was administered to patients with CPAPC locally advanced, for 2 years after standard treatment with radio-chemotherapy. Compared with patients who received only standard treatment, patients treated with the new drug had an extended life expectancy of almost 2 years 1whether or not their tumor expresses the PDL1 marker.
“ This is the first time that immunotherapy has improved the survival of patients with small cell lung cancer » enthuses Professor Girard. With such results, this immunotherapy becomes the new standard of treatment, in addition to radio-chemotherapy.
When will French patients be able to benefit from it? “ To have access to it, the Astrazeneca laboratory, which developed this drug, must submit a request for early access to the High Authority of Health and the latter must authorize it. » explains Professor Girard. “ Our teams are currently working on the subject to hope to obtain access as soon as possible. » the laboratory communications manager confirmed to us. Upon receipt of the request, the HAS has 3 months to examine the file. If accepted, Astrazeneca will have to make the medicine available to patients within 2 months.
WHAT YOU MUST REMEMBER
The treatment : durvalumab immunotherapy for 2 years, after radio-chemotherapy (standard treatment)
The patients concerned: patients with locally advanced small cell lung cancer
The benefit obtained: extension of life expectancy by almost 2 years
New standard of treatment for EGFR mutated non-small cell lung cancer
This time it is the most common type of lung cancer, non-small cell lung cancer (NSCLC), that the study LAURA was interested. More particularly to the subtype presenting a EGFR mutation.
In this trial, the effectiveness of a targeted therapyL’osimertinib (Tagrisso©), was tested in continuous administration after standard treatment with radio-chemotherapy in patients with CPNAPC locally advanced and mutated in EGFR. Result: an 80% reduction in the risk of relapse.
“ Again, this will become a new standard of treatment » confirms Professor Girard. And regarding its access? “ For osimertinib, it’s a little different. It is a medication in tablet form dispensed in community pharmacies. Given the importance of its benefit, it will be tempting to prescribe it without waiting for marketing authorization for this indication. Remember that in this cancer, relapses are often cerebral. It is better to prevent them than to treat them. » justifies the pulmonologist.
WHAT YOU MUST REMEMBER
The treatment : continuing to take osimertinib, a targeted therapy, after radiochemotherapy (standard treatment)
The patients concerned: patients with locally advanced non-small cell lung cancer with EGFR mutation
The benefit obtained: an 80% reduction in the risk of recurrence
Soon a new treatment for metastatic EGFR mutated non-small cell lung cancers
Still in the CPNAPC EGFR mutatedbut this time in condition metastaticthe clinical trial HARMONi-A studied the effectiveness of ivonescimab in previously treated patients. “ It is an antibody with a dual target: both immunotherapy (anti-PD1, editor’s note) and anti-angiogenic (anti-VEGF, editor’s note)” explains Professor Girard.
Combined with chemotherapy, this innovative treatment has reduced the risk of disease progression by half. “ This is the first time that immunotherapy has been shown to be effective in patients with an EGFR mutation, probably because it is combined with an anti-angiogenic drug. » specifies Professor Girard.
These results were obtained in a Chinese population. A clinical trial is still underway in Europe. Patients can be included in France.
WHAT YOU MUST REMEMBER
The treatment : the combination of ivonescimab, an antibody targeting 2 targets, in combination with chemotherapy
The patients concerned: patients with metastatic non-small cell lung cancer and EGFR mutation, previously treated
The benefit obtained: halving the risk of disease progression
Confirmation of the place of lorlatinib in metastatic ALK-mutated non-small cell lung cancers
Concerning tumors presenting ALK mutationa rare genetic alteration that mainly affects women, the latest data from the study CROWN confirm the place of lorlatinib (Lorviqua©). Thanks to this small inhibitory molecule, given as first intention in cancers metastatic, 60% of patients have lived for 5 years with a disease whose progression is controlled. “ This is the longest survival ever reported with targeted therapy in solid cancer » notes Professor Girard.
This drug has been accessible to French patients since the publication of previous work which had already demonstrated its interest.
WHAT YOU MUST REMEMBER
The treatment : lorlatinib
The patients concerned: patients with metastatic non-small cell lung cancer and ALK mutation
The benefit obtained: disease progression controlled in 60% of patients for at least 5 years
1. In median.
Doctor of biology, science journalist and editor-in-chief of the Rose magazine website
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