What’s new in lung cancer treatment?

January 8, 2019 in Disease Management  •  By Miles Varn, MD
lung cancer

There are several newer treatment options that people who have been diagnosed with non-small cell lung cancer (NSCLC), the most common form of the disease, may want to discuss with their doctor.

For people who have early stage lung cancer, surgery is the standard treatment recommendation. But those who are older or in poorer overall health often are not good candidates for surgery because of the risk of complications. Many of these people undergo several sessions of stereotactic radiotherapy, which uses targeted doses of radiation to destroy tumor cells, but there are some potential drawbacks, including harming healthy tissue near the tumor. A study published earlier this year in Radiology found that a one-time treatment with thermal ablation was an effective alternative. During thermal ablation, a probe is placed directly in the tumor to deliver extreme heat or cold or radio waves to destroy cancer cells. In the study, the effectiveness of thermal ablation was comparable to stereotactic radiotherapy, delivering a two-year survival rate of 65%. Researchers are now starting studies to see if the effectiveness of thermal ablation could be increased by the addition of immunotherapy to the treatment plan.

Another recent study focused on the use of immunotherapy in combination with standard chemotherapy to treat people with a form of advanced lung cancer known as metastatic nonsquamous non-small cell lung cancer. In the study, the people who received a combination of chemotherapy and pembrolizumab (sold under the brand name Keytruda) were 51% less likely to die over a period of 10.5 months than people who received chemotherapy and a placebo. Those receiving both pembrolizumab and chemotherapy also experienced a median progression-free survival time (period during which their disease did not get worse) of nine months compared to only five months for those in the study’s control group. In addition, the people who received both immunotherapy and chemotherapy were also significantly less likely to have their cancer spread.

Researchers conducted another study focused on the effectiveness of immunotherapy compared to chemotherapy. In that study, patients received either a combination of the immunotherapy drugs nivolumab (brand name Opdivo) and ipilimumab (brand name Yervoy) or standard chemotherapy alone. The patients who received the immunotherapy drugs were 42% less likely to experience the progression of their lung cancer after a year compared to those who received chemotherapy.

For people who have been treated with nivolumab but whose metastatic non-small cell lung cancer has stopped responding to the drug, an early phase clinical trial recently completed by researchers at the Hollings Cancer Center at the Medical University of South Carolina may offer another treatment path in the years to come. The researchers combined nivolumab with a new drug that stimulates the immune system, ALT-803. Larger clinical trials of the new treatment approach are needed before the therapy becomes available to patients.

If you or a loved one has been diagnosed with lung cancer, the first step in developing a treatment plan is to talk with your doctor about the complete range of options available, including clinical trials.