An international clinical trial involving the McGill University Health Centre (MUHC), the Centre hospitalier de l’Université de Montréal (CHUM), and St. Mary’s Hospital Center (SMHC) is set to revolutionize the way non-small cell lung cancer (NSCLC)—the most common type of lung cancer—is treated.
The Trial
In this trial, the immunotherapy drug pembrolizumab (KEYTRUDA), used before (neoadjuvant) and after surgery, was shown to slow cancer progression and recurrence and reduce the presence of residual tumors in patients with early-stage operable NSCLC.
In the experimental group, three out of five patients remained stable for two years without cancer progression or recurrence, compared to two out of five in the control group, marking an improvement of about 50 percent.
The interim analysis of this Phase III clinical trial was presented at the American Society of Clinical Oncology (ASCO) 2023 Annual Meeting and published in The New England Journal of Medicine.
Improving Cancer Survival
The trial enrolled patients with surgically removable stage II or III NSCLC, stages that were previously associated with less than 50 percent survival rate five years after diagnosis.
Half of the patients received neoadjuvant pembrolizumab plus cisplatin-based chemotherapy followed by surgery and adjuvant pembrolizumab.
The other half received neoadjuvant chemotherapy and surgery alone, with a placebo instead of pembrolizumab.
Findings
Out of 797 adult participants, 344 (43.2 percent) experienced an event (such as local tumor progression that precluded the planned surgery, cancer recurrence, or death) or died; most of the events were disease progression or recurrence.
Event-free survival at 24 months was 62.4 percent in the pembrolizumab group and 40.6 percent in the placebo group.
Moreover, the trial showed that the treatment reduced tumor size.
A major pathological response occurred in 30.2 percent of the participants in the pembrolizumab group and in 11.0 percent of those in the placebo group, and a pathological complete response occurred in 18.1 percent and 4.0 percent, respectively.
The addition of pembrolizumab did not interfere with surgical choices, surgical ability, or the incidence of surgical complications.
Conclusion
This new treatment brings hope for NSCLC patients, significantly improving survival rates when combined with neoadjuvant chemotherapy.
It applies to all patients with stage II or III NSCLC who are eligible for surgery, marking an important step toward better outcomes for this common type of lung cancer.
The success of this study puts Montreal among the major players in the world of randomized clinical trials in thoracic oncology, showcasing the significant achievements of highly collaborative teams in thoracic oncology.
If you care about cancer, please read studies about dry shampoo and cancer risk, and vitamin D supplements strongly reduces cancer death.
For more information about health, please see recent studies about how drinking milk affects the risks of heart disease and cancer and results showing higher intake of dairy foods linked to higher prostate cancer risk.
The study was published in the New England Journal of Medicine.
Copyright © 2023 Knowridge Science Report. All rights reserved.
