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The life expectancy of patients with small cell lung cancer can be extended with immunotherapy

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Immunotherapy blocks the activity of a protein called PD-L1, which makes it easier for immune cells to fight and kill cancer cells.

Patients with small cell lung cancer without metastases outside the chest cavity (LS-SCLC) live longer if they receive immunotherapy for two years after standard treatment. This is evident from the global ADRIATIC study led by radiation oncologist Suresh Senan (Amsterdam UMC Cancer Center Amsterdam): “Treatment for these patients has remained the same for decades. This study shows that these patients should receive additional immunotherapy.”

In most patients with small cell lung cancer detected at an early stage, standard chemotherapy treatment with radiation works well. The cancer disappears completely, the tumor shrinks or the number of tumors decreases. After treatment, patients remain under control. However, the prognosis is still poor, as the cancer often returns within two years. The researchers wanted to know if immunotherapy after standard treatment could change this poor prognosis. Immunotherapy blocks the activity of a protein called PD-L1, which makes it easier for immune cells to fight and kill cancer cells. In 2018, the ADRIATIC trial began in patients who had received conventional chemotherapy and radiation therapy: for two years, 730 patients from 164 centers in 19 countries received either immunotherapy or placebo every four weeks.

First results from the ADRIATIC study
The results of the study are promising. Patients who received immunotherapy improved overall survival by 22.5 months compared to patients who received placebo. The average risk of death was reduced by 27% compared to placebo-treated patients. Patients also had a greater chance of living longer without the cancer growing back. The average risk of cancer recurrence or death was 24% lower with immunotherapy compared with placebo. Immunotherapy caused side effects, but they usually did not lead to treatment discontinuation. Senan: “The numbers speak for themselves. Such a big improvement is rare.”

Recommendation
Data from the ADRIATIC study support immunotherapy as a new treatment option for LS-SCLC patients whose tumors have disappeared, shrunk, or remained stable after conventional chemotherapy-radiotherapy. Therefore, researchers recommend additional treatment for this group of patients. Before such treatment can be applied in the Netherlands, the drug must first be approved in Europe and then reimbursed in the Netherlands.

The results of this study were presented on Sunday, June 2 at the American Society of Clinical Oncology (ASCO) conference in Chicago.

Source: Amsterdam UMC


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