Immunotherapy Offers New Options for Lung Cancer Treatment

Joan H. Schiller, MD, is a board-certified medical oncologist specializing in lung cancer. 

Lung cancer kills more people worldwide than any other cancer. The American Cancer Society estimates that 154,050 men and women in the United States alone will die from the disease this year. Yet that number could start to shrink, thanks to remarkable new medications that are helping people with lung cancer live longer.

In mid-April, at the annual meeting of the American Association for Cancer Research, investigators shared exciting results from a study of immunotherapy for lung cancer. Immunotherapy is a treatment that employs a patient’s own immune system to fight cancer. This particular study involved a certain type of immunotherapy called PD-L1 or PD-1 inhibitors – and the findings could have a big impact on the way we treat lung cancer in the future.

Lung Cancer: Living Longer

The big news from the conference was a study of an immunotherapy drug called pembrolizumab, or Keytruda. The researchers studied more than 600 people with a type of lung cancer called non-squamous non-small cell lung cancer. All of the patients had advanced disease. Some of the patients received a standard chemotherapy, while others took chemotherapy plus Keytruda.

The results were striking. Those who took Keytruda plus chemotherapy were 51 percent less likely to die than those who received only chemotherapy. After 12 months, 69.2 percent of the people in the immunotherapy group were still alive, compared with 49.4 percent of those who took chemotherapy alone.

At the same conference, other researchers reported that an immunotherapy drug known as nivolumab (or Opdivo) could shrink lung cancer tumors and prevent the cancer from spreading when given to patients before surgery. Though this study was smaller and more preliminary, it offers additional evidence that immunotherapy is poised to become an important tool for treating lung cancer.

Keytruda Can Benefit More Patients

Keytruda isn’t a new drug. The Food and Drug Administration (FDA) has already approved it for certain diseases and patients, including those with non-small cell lung cancer whose disease has progressed after being treated with chemotherapy.

It’s also approved for patients whose tumors have high levels of a marker called PD-L1. PD-L1 acts like a mask, allowing the cancer cells to hide from the body’s immune system. Keytruda blocks the PD-L1 pathway, pulling back the mask and making the cancer vulnerable.

What’s surprising about this new study is that the combination of chemotherapy and Keytruda is so effective, even in patients who don’t have high levels of PD-L1. That suggests there’s good reason to give immunotherapy in addition to chemotherapy to more lung cancer patients – and to start immunotherapy earlier in the treatment process.

Extending Lives

Scientists have been studying immunotherapy since the 1980s, but the early results weren’t very promising. The first drugs didn’t work well for most people, and they often caused serious side effects. Even now, immunotherapy isn’t perfect. Not everyone responds to the drugs, for reasons we don’t yet understand. And in some patients, these treatments can cause the immune system to attack healthy organs, resulting in serious side effects.

In most patients, though, the side effects are minimal – and typically much less severe than the common side effects of chemotherapy. Given the exciting new research findings, I expect it won’t be long before the FDA approves Keytruda for use with chemotherapy in more lung cancer patients. And this is only the beginning. As researchers continue to fine-tune these therapies, I’m hopeful we’ll be able to help more people with lung cancer live longer lives, with fewer and fewer side effects.

The expert team at Inova’s Lung Cancer and Thoracic Malignancies Program provides the latest treatment options, including cutting-edge clinical trials. Give Inova a call at 703-504-3001 to schedule a lung cancer screening, or find a location near you to make an appointment with one of our doctors who specialize in the treatment of lung cancer.