Immunotherapy Now an Option for Many More Lung Cancer Patients

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For the most common type of lung cancer–non-small cell lung cancer–there is a major new advance in the treatment protocol you may be offered. A study recently presented by Dr. Leena Gandhi, previously of NYU Perlmutter Cancer Center, found that combining the immunotherapy drug Keytruda with chemotherapy can dramatically improve survival odds. The combination reduced the risk of death by 51%.

“It represents a sea change in the way we think about treating lung cancer,” Dr. Gandhi said. People with metastatic non-squamous, non-small-cell lung cancer can now activate their own immune system through the combination of immunotherapy and chemotherapy to kill malignant cells. This new option may extend life by many years.

Immunotherapy treatments are showing enormous promise in several cancers. Four checkpoint inhibitor drugs have already been approved for lung cancer, and are likely to be covered by insurance companies. These are man-made antibodies that target key proteins like PDL-1 on tumor cells, thus halting the cancer’s ability to grow and reproduce. But these drugs have only worked in a small number of patients, have high costs and side effects can be debilitating.

Keytruda, for example, costs about $150,000 and is made by the pharmaceutical company Merck. Currently, it is approved as an initial lung cancer treatment for patients with high levels of certain biomarkers. But in Dr. Gandhi's clinical trial, when the drug was used in combination with chemotherapy, it helped patients with a wide variety of biomarker levels.

Opdivo, a competing drug from Bristol-Meyers Squibb, works in a similar way and is also being tested in clinical trials in combination with chemotherapy. Taken as combination treatments, these immunotherapy drugs may make a big difference in overall survival.

“If you want to extend life, you’ve got to give immunotherapy as soon as possible. I’ve been treating lung cancer for 25 years and I’ve never seen such a paradigm shift as we are seeing with immunotherapy,” said Dr. Roy Herbst, Chief of Medical Oncology at the Yale Cancer Center and a medical reviewer for SurvivorNet.

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