Dr. Weeks’ Comment: Cancer spreads by inflammation – these are the 4 most important words in cancer care.

Chemo and radiation make your cancer worse – says Max Wicha on the National Cancer Advisory Board – because they kill cancer TUMOR cells but make cancer STEM cells more numerous and more virulent. Now we are seeing more success with immunotherapy – where the body kills the cancer. But for immunotherapy to work you you anti-inflammation diet with SOUL and detoxification with CORE

Unprecedented Survival in Lung Cancer With Immunotherapy

Pam Harrison

September 12, 2019

BARCELONA, Spain — Immunotherapy in the form of programmed cell death (PD-1 and PD-L1) inhibitors is rapidly transforming the landscape in advanced non-small cell lung cancer (NSCLC), extending progression-free survival and even overall survival (OS) in some patients to unprecedented lengths without significantly compromising quality of life, say experts.

“Historically, overall survival in advanced NSCLC was less than 5% at 5 years,” Federico Cappuzzo, MD, PhD, director of medical oncology at AUSL della Romagna in Ravenna, Italy, told a press briefing here at the IASCL 2019 World Conference on Lung Cancer.

“Today we have a growing proportion of patients of between 15% and 20% who are alive after 5 years, and this is an important message for our patients — that the possibility of extending life is increasing with immune therapies,” he said.

First Report of 5-Year Overall Survival in Lung Cancer

The first report from any randomized trial to document 5-year OS rates in NSCLC, presented by Scott Gettinger, MD, Yale School of Medicine, New Haven, Connecticut, showed that 13.4% of patients treated with single agent nivolumab (Opdivo, Bristol-Myers Squibb) were still alive at 5 years compared with only 2.6% for those treated with docetaxel (Taxotere, sanofi-aventis) .

“This is really unprecedented — we would never have expected any patients to be alive out to 5 years in this scenario, and this was in both squamous and non-squamous cell lung cancer,” Gettinger said.

The finding is based on pooled results from the similarly designed CheckMate 017 and 057 trials, he noted.

Furthermore, progression-free survival (PFS) again at 5 years was 8% in the nivolumab arm vs 0% in the docetaxel arm.

“More commonly, we see zero patients without progression at 5 years, and that is exactly what we saw with the docetaxel arm,” Gettinger confirmed.

Median duration of response was 19.9 months for patients who received nivolumab vs 5.6 months for their docetaxel counterparts. At 5 years, almost one third of patients who responded to the immune checkpoint inhibitor were still without disease progression.

Indeed, “we found that 60% of patients across these two trials who did not have disease progression at 2 years still did not have progression at 5 years, with 82% of them still being alive at 5 years,” Gettinger noted.

Similarly, if patients made it out to 3 years without disease progression, 78% were still without progression at 5 years and 93% of them were still alive at the same time point.

For those who made it out to 4 years without disease progression, 88% were still without progression at 5 years, all of whom were still alive at 5 years, he added.

Importantly, “we saw no new safety signals with long-term nivolumab,” Gettinger observed, “and there was no evidence of late-onset grade 3 or 4 treatment-related adverse events (AEs).”