Drug company AstraZeneca’s once-daily pill halved deaths in some early-stage lung cancer patients undergoing surgery, according to new clinical trial results.
It was discovered that Presented On Sunday, I attended the Annual Meeting of the American Society of Clinical Oncology in Chicago, and at the same time published It was published in the New England Journal of Medicine.
The data are the first to show how targeted therapy in early-stage lung cancer impacts survival, said Roy Herbst, M.D., principal investigator of the trial and associate director of the Yale Cancer Center. Stated. Called osimertinib and marketed under the name Tagrisso, the drug targets specific receptors that help cancer cells grow.
“I think some patients are cured. Lung cancer is progressing like never before,” Herbst said.
The test results were “about twice as good as we expected,” Herbst added.
In an international study of 682 lung cancer patients, approximately half of the participants received daily pills for three years, and the other half received a placebo. Five years after diagnosis, 88% of the group taking the pill were still alive, compared with 78% of the placebo group. The study was funded by AstraZeneca and involved people from more than 20 countries in the US, Europe, South America, Asia and the Middle East.
Researchers found that the drug reduced the overall risk of dying from lung cancer by 51%.
Last year, the Biden administration set a moonshot goal of reducing cancer mortality in the United States by at least 50% over 25 years.
“In at least this one area, we’re right on target,” Herbst said.
Tagrisso is already approved in more than 100 countries, including the United States. In 2015, the Food and Drug Administration approved the drug for advanced lung cancer patients whose disease worsened on or after taking other drugs. Treatment.And in 2020, the agency will Approved Tagrisso those in the early stages of the disease.
Herbst’s team showed three years ago that Tagrisso prevented tumors from recurring and prevented cancer from spreading to the brain, liver and bones.
“We already knew that this drug worked, but what we’re seeing now is that it also extends the lives of patients,” said Dr. Chal Agarwal, assistant professor at the University of Pennsylvania Perelman School of Medicine. said. Not involved in research.
The trial included patients with stage 1, 2 and 3 non-small cell lung cancer, the most common type of lung cancer.
Participants also had mutations in a receptor called EGFR. Receptors normally help cells grow, but mutations can cause cells to divide and proliferate excessively, causing cancer. Herbst said the pill acts as an “off” switch for the mutated receptor.
around it 10–15% of lung cancer cases The US has an EGFR mutation, but it is more common in Asia and Australia. This mutation is usually detected in people with little or no history of smoking.
Herbst said the new survival data may encourage more doctors to prescribe the drug. He said the data could also encourage more insurance coverage for the pill. Because treatment is expensive, insurance companies prefer to see life-prolonging benefits before deciding to reimburse expensive drugs.
Prior to the availability of targeted therapies like Tagrisso, patients with stage 1-3 lung cancer typically received chemotherapy after surgery, said Patrick Forde, associate professor of oncology at Johns Hopkins Medical School. . He estimated that this could improve the chances of survival by about 5% compared with patients who did not receive chemotherapy. (Forde was not involved in the new study, but he has previously consulted with AstraZeneca and obtained research funding from the company.)
“Five years ago, this group of patients would probably have been expected to survive 50% at five years,” he said. “But with advances in both stage 4 cancer and this early stage cancer, we are now at 88%.”
After surgery, doctors may still recommend both chemotherapy and Tagrisso, Forde said.
Compared to chemotherapy, Tagrisso has few serious side effects. Herbst said some people taking the pills have experienced skin rashes and mild diarrhea, but overall the drug was “pretty well tolerated.”
Jill Feldman, a lung cancer patient who has taken Tagrisso for more than four years, said the drug stopped the progression of her cancer and said it can be easily taken at home in pill form. But even side effects that aren’t life-threatening can change a patient’s life, she added. Feldman, 53, of Deerfield, Illinois, said she has been experiencing diarrhea, mouth ulcers, fatigue and nail bed skin infections since she started taking the drug.
One question that remains, Dr. Ford said, is whether patients will survive the same if they are given the pill after their cancer has recurred versus if they are given it immediately after surgery. However, doctors generally recognize that treating cancer early improves survival.
However, early screening remains a challenge. In most cases, doctors don’t do extensive screenings to catch lung cancer before it spreads to other parts of the body, Forde said.United States Preventive Services Task Force It is recommended Annual lung cancer screening in selected adults aged 50 to 80 who have ever smoked.
“Only about 5% of patients are getting adequate screening, which is in contrast to things like mammography for breast cancer and cervical cancer screening,” Forde said.
Agarwal said many lung cancer patients are not even tested for EGFR mutations. The new data could serve as a “call to action” for more such testing, she said.
