Targeted therapy extends life in some types of lung cancer

Any improvement in overall survival is the holy grail sought in oncology. This is what American, Japanese and Chinese researchers have managed to show in trials of a particular type of lung cancer that affects between 1,000 and 1,500 French people every year. The results were seen during their presentation at the International Cancer Congress (Asco) in Chicago from Friday.

The trial, called Adaura, involved 682 volunteers diagnosed with operable (ie, non-metastatic) non-small cell lung cancer that carries the EGFR genetic mutation. All patients had their tumors surgically removed, then about half took a daily dose of osimertinib, sold by AstraZeneca under the name Tagrisso, for three years. The other group took a placebo for the same period. Some, in both groups, also had one or more courses of chemotherapy.

The advantage of osimertinib is very clear on the risk of relapse. only 27% of patients treated with this molecule saw their cancer return during the study period, compared to 60% in the placebo group. More importantly, five years after the start of the study, overall survival in the group treated with targeted therapy was 88%, compared to 78% in the placebo group. A “significant” benefit, according to the authors, in a study published in parallel New England Journal of Medicine. The gain was more noticeable in patients whose cancer was the most severe but who went on to have surgery, with a difference of 18 points compared to the placebo group.

Already assigned to France

These pleasant results confirm the therapeutic strategy adopted in France for more than a year. Indeed, osimertinib is already routinely prescribed in the same patient profile, and as of early 2022, the drug has received reimbursement from Social Security and Temporary Authorization for Use (ATU) for three years. “ For the patient, therefore, there will be no revolution compared to what we already practice »translated by P^r: Benjamin Bess, Director of Clinical Research at Gustave-Roussi. This therapeutic strategy was adopted based on previous results published two years ago. “ Osimertinib has already been shown to protect patients from relapse, particularly in the brain. »says P^r: Nicolas Girard, oncologist and pulmonologist head of the Curie-Montzouris Chest Institute.

Targeted therapy can only be given to patients whose tumors carry the EGFR mutation. “ The results presented in Asco also prove that it is preferable to treat all patients (mutation carriers, after surgery, editor’s note) immediately, even if we do not know who is likely to relapse, than to wait for cancer to develop. go back and heal it “, explains Nicolas Girard. The oncologist remembers, however, only that operation “ cures most patients it remains the mainstay of treatment. »

“ It is also not a systematic alternative to chemotherapy, but an additional advance in the recovery of certain patients. “, emphasizes D^r: Clarisse Audigier-Valette, lung cancer, head of the multidisciplinary medicine and oncology center at Toulon-Sainte-Muse hospital center.

Before that, the same molecule had been prescribed for five years to patients with similar cancer, but in the metastatic stage. A step back that allows you to know this therapy well. “ It is a fairly well-tolerated drug, although it is not without skin or gastrointestinal adverse effects that can alter quality of life when taken daily for three years. »points out Benjamin Besse.