This article is taken from the monthly journal Sciences et Avenir - La Recherche #910 of December 2022.
Real change. “Unthinkable a few years ago, now it is possible to control the development of the disease even in the presence of metastases for almost ten years,” insists Professor Christos Shuaid, pulmonologist at the Creteil Intercommunal Hospital Center.
Indeed, in facing this multiple form of lung cancer (there are almost 100 different types, the most common of which is the so-called non-small cell, NSCLC), significant progress has been made. Bottom line: yesterday’s forecast, which was still very bleak, continues to improve. Classically, three approaches are suggested, sometimes combined depending on the prevalence of the cancer at the time of diagnosis, the age of the patient, and any other medical conditions: surgery (feasible in one in five cases, the cancer is often detected too late), chemotherapy, and radiotherapy.
This article is taken from the monthly journal Sciences et Avenir - La Recherche #910 of December 2022.
Real change. “Unthinkable a few years ago, now it is possible to control the development of the disease even in the presence of metastases for almost ten years,” insists Professor Christos Shuaid, pulmonologist at the Creteil Intercommunal Hospital Center.
Indeed, in facing this multiple form of lung cancer (there are almost 100 different types, the most common of which is the so-called non-small cell, NSCLC), significant progress has been made. Bottom line: yesterday’s forecast, which was still very bleak, continues to improve. Classically, three approaches are suggested, sometimes combined depending on the prevalence of the cancer at the time of diagnosis, the age of the patient, and any other medical conditions: surgery (feasible in one in five cases, the cancer is often detected too late), chemotherapy, and radiotherapy.
But in 2022, we can also look forward to two major waves of recent innovations, so-called targeted therapies and immunotherapy. Two achievements are still little known to the general public, as evidenced by a poll of a thousand people over 18 in July last year, where only one in five Frenchmen cites them.
Look for the Achilles heel of the tumor
The so-called targeted therapy is intended for surgically removed tumors, for which molecular genetic analysis carried out on about thirty platforms existing in France reveals the presence of specific genetic mutations (Egfr, Kras, Braf, ALK, etc.). .). How many Achilles’ heels of a tumor, which can sometimes (in 15% of cases) be affected by precisely these methods of treatment, precisely directed against this mutation, more effective than chemotherapy, and less generators of side effects.
The second is immunotherapy, an approach that involves stimulating the patient’s immune system so that its own cells, the lymphocytes, directly attack the tumor cells. “But over time, phenomena of resistance appear, and we do not yet have the tools to predict their success or failure,” says Christos Shuaid.
Find the best combinations
Pending their development and other advances to better cover the remaining needs, oncologists are constantly finding the best combinations among these different approaches, sometimes even before resorting to surgery if possible. An example from the international study ChekMate-816, phase 3 results from 358 patients were presented last April by Professor Nicolas Girard (of the Curie Institute, Paris) at the American Association for Cancer Research (AACR) congress.
It has been shown that the addition of immunotherapy to conventional chemotherapy for so-called localized non-metastatic cancer reduced the risk of recurrence by 40% in the treated group. If this new association has received the green light from the Food and Drug Administration in the United States, its access in France is pending for now.