A groundbreaking study has brought new hope to people with a common type of lung cancer known as non-small cell lung cancer (NSCLC).
Researchers from Weill Cornell Medicine, NewYork-Presbyterian, and Columbia University Vagelos College of Physicians and Surgeons have made an exciting discovery.
They found that combining low-dose radiation with immunotherapy can be more effective than using immunotherapy alone for NSCLC patients.
NSCLC is a major health concern, as it accounts for 81% of all lung cancer cases in the United States. Typically, patients with lung cancer are treated with a mix of chemotherapy and immunotherapy.
However, this new study, which was published in Nature Communications on December 19, suggests a different approach.
The lead author of the paper, Dr. Nasser Altorki, who heads the Division of Thoracic Surgery at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center, explained that low-dose radiation could be a better option, especially for patients who struggle with chemotherapy.
Zachary Walsh, an MD/Ph.D. candidate at Columbia University, also played a significant role as a co-first author of the study. The study’s roots go back to an earlier clinical trial conducted at NewYork-Presbyterian/Weill Cornell Medical Center.
In this trial, 60 patients with early-stage NSCLC received a combination of radiation and durvalumab, an immunotherapy drug.
Durvalumab helps the immune system attack cancer cells, but it doesn’t always do enough to get rid of the cancer completely.
What made this trial special was its use of low-dose radiation to boost the immune system’s response, instead of using high doses to kill the tumor.
Timothy McGraw, a co-senior author and professor at Weill Cornell Medicine, highlighted this unique aspect of the trial.
Another co-senior author, Dr. Benjamin Izar from Columbia University and NewYork-Presbyterian/Columbia University Irving Medical Center, contributed significantly to this work.
Initial results published in The Lancet Oncology in 2021 were promising. The combo treatment removed more tumors than immunotherapy alone, achieving a “major pathological response” in many cases. This meant that more than 90% of the cancer cells in the removed tumors were destroyed.
The big question was whether this treatment would also help patients live longer without their cancer getting worse. To find out, the team kept an eye on the patients for an extra two years. The extended study’s results were encouraging.
The combination of therapies not only lowered the risk of cancer coming back but also extended the time patients lived without their cancer progressing.
In the group receiving only immunotherapy, six people died of cancer. But in the group receiving both treatments, there was only one cancer-related death.
Interestingly, the researchers found that the patients who responded well to the dual therapy had more active T cells in their blood. These are the cells that help fight off diseases like cancer.
Even before treatment started, some patients had special T cells in their blood, which usually don’t circulate. This hinted that their immune systems were already fighting the tumor.
By studying these T cells, doctors might be able to predict who will benefit most from the combination treatment.
Dr. Altorki and his team are excited about these findings and plan to compare radiation with chemotherapy in boosting immunotherapy in future trials.
They hope to answer a big question: Is radiation as good as or even better than chemotherapy in helping immunotherapy work? This could be a game-changer in treating lung cancer.
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The research findings can be found in Nature Communications.
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