New hope in the treatment of lung cancer… and other cancers too?

[15 June 2007 - 11h33]
[mis à jour le 15 June 2007 à 11h34]

With a 15% average 5-year survival rate, all stages taken together, “non-small cell” lung cancer (NSCLC) is one of the cancers with the most troubling prognosis. While it’s true that with early detection at a localised stage there is hope of 50% survival at 5 years, this situation only refers to barely a third of patients.

In Chicago, however, at the 43rd Annual Meeting of the American Society of Clinical Oncology (ASCO), various studies have provided a glimpse of hope in the treatment of these tumours, which account for 80% of lung cancer cases. According to the WHO, every year NSCLC causes 1.3 million deaths worldwide.

On the second day of the Meeting, the German doctor Christian Manegold (from the University of Mannheim) reported on the improvement that an angiogenesis inhibitor, bevacizumab (Avastin, Roche) appears to deliver when used in combination with gemcitabine and cisplatin chemotherapy in metastatic patients. A study of over 1,000 patients assessed the results of two different therapeutic regimes. Paradoxically, it would seem that the lowest doses of bevacizumab produced the most favourable results. This will however need to be verified when information on overall patient survival becomes available, certainly not before the end of 2008.

At this stage early conclusions are encouraging. The response rate to treatment has been increased by 70% (50% in the group treated with the higher dose) and the average duration of response to treatment has increased by 30% in both groups. And the median progression-free survival (PFS) has been extended by 9.8% in the group that received the lower dose, compared with 6.5% in the other. The gain in PFS – which increased from 6.1 months to 6.7 months on average – may appear modest but these are in fact major victories given the gravity of the prognosis for NSCLC.

A breakthrough in the field of immunotherapy?

Another study, presented 3 days later by a team from the University of Louvain (Belgium), offered possible new hope in the field of immunotherapy. At this stage there has only been a randomised phase II trial but with an average of 182 patients monitored over 28 months, the results are considered so encouraging that a phase III trial is currently being set up. The study in question will involve 59 teams in 14 countries.

Taking as their starting point the fact that between 35% and 50% of patients with non-small cell bronchial cancer express a specific antigen (the antigen MAGE-A3) on the surface of the cancer cells which is absent from all healthy cells, researchers at the GSK group developed an antigen-specific cancer immunotherapeutic (ASCI) specifically targeting this antigen in patients who had had surgery for NSCLC. This vaccine was administered at five successive 3-week intervals, then at eight 3-month intervals and produced a 27% reduction in recurrence after surgery. A press release distributed by GSK following the presentation points out that these are “trends”. They are however considered sufficiently tangible for a phase III study involving over 2,200 patients to be set up.

As Dr Thierry Le Chevalier, vice president of the Oncology Development Centre at GSK explains, “the MAGE-3 antigen is not only present in lung cancer. It is also present in cancer cells in the bladder, the head and neck and in melanomas.” Which means that if these trials yield concrete results it could be that an entire area of cancer study will be opened up to new therapeutic approaches.

Source : from our special correspondents in Chicago, at the Annual Meeting of the American Society of Clinical Oncology, 1-5 June 2007 GSK, 5 June 2007

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