ASCO 2021. The benefits of early immunotherapy against lung cancer, the deadliest on Earth

It remains the deadliest cancer on the planet: two million deaths per year worldwide, with less than 20% of patients still alive five years after diagnosis.

45,000 new cases and 33,000 deaths in France each year

In France each year, it is about 45,000 new cases and 33,000 deaths. Faced with this type of cancer, the prognosis often depends on the stage of development at the time of discovery.

While the so-called stage 1-2, localized, can often be cured by surgery, the others, 3, locally advanced and 4, metastatic, also require the use of chemotherapy, targeted therapy and radiotherapy.

But until now, it was rather the most advanced forms, metastatic, which benefited from the contribution of immunotherapy. Gold, plSeveral works presented this year at ASCO 2021 show that less advanced forms also benefit from this approach.

“This study shows that its effectiveness is maintained for five years”

Example with the Impower 10 study who investigated the addition of aezolizumab (Tecentriq, Genentech, Roche) in nearly 1,200 patients. This anti-PDL1 has been combined with adjuvant chemotherapy prescribed after surgical removal of the tumor. A phase 3 clinical trial which demonstrates a gain in progression-free survival of the disease.

Another example with the Pacific study. Carried out with another anti-PDL1, durvalumab (Infinzi, AstraZeneca), a molecule already mentioned in previous ASCOs, Pacific has just demonstrated good results five years after its administration. Two groups of 700 patients received, after chemo and radiotherapy, either durvalumab or a placebo. Five years after the end of the study – the last patient to finish treatment in May 2017 – overall survival data is 42% in the durvalumab group compared to 33% in the placebo group.

“This study shows that its efficacy is maintained for five years and that the risk of death at five years is reduced by 28% in the durvalumab group”, commented Dr David Planchard, thoracic oncologist and head of the Thoracic Pathology committee, Institut Gustave Roussy (Villejuif), who participated in the trial.

Immunotherapy could therefore be introduced earlier and earlier in patients with lung cancer. And the question of when to introduce immunotherapies is already being asked, probably more and more early in the future. Response in other ASCOs to come.

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