Compiled by Magnolia Ark Team | Chemotherapy is often accompanied by many inevitable side effects, destroying the body of tumor patients. As researchers explore the pathogenesis of lung cancer in depth, the emergence of dual immunotherapy has provided new treatment directions for many lung cancer patients who are unwilling to or unable to chemotherapy. The era of "dechemotherapy" may be coming . Research data points out that the emergence of dual immunotherapy has further prolonged the survival of lung cancer patients and effectively improved the prognosis of lung cancer patients .
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O+Y dual immunotherapy significantly prolongs the survival of lung cancer
In May 2020, the U.S. Food and Drug Administration (FDA) approved the PD-1 inhibitor nivolumab (Nivolumab, OPDIVO, "O" drug) dual immunotherapy combination with CTLA-4 inhibitor ipilimumab (Iipilimumab, Yervoy, "Y" drug), is used for the first-line treatment of advanced non-small cell lung cancer without EGFR or ALK gene driver mutations and PD-L1 positive (expression ≥1%). This is the first and only dual immunotherapy approved by the FDA.
▲Photo source: Reference source [2]
2021 First edition of the NCCN non-small cell lung cancer guideline, for patients who found that gene detection found that PD-L1 is highly expressed, the dual immunotherapy combination of O+Y was included in the level 1 recommended ; and in patients with low expression in PD-L1, that is, PD-L1 expression level is 1%~49%, the recommended level of dual immunotherapy for O+Y has also been upgraded from level 2A to level 1 recommended .
Note: Level 1: Based on high-level evidence, the expert group reached a consensus and recommended
Why does dual immunotherapy become a strongly recommended drug for the first-line treatment of non-small cell lung cancer? Studies have confirmed that dual immunotherapy has shown outstanding effects in the field of non-small cell lung cancer treatment, which significantly prolongs the patient's survival time compared with chemotherapy.
The results of CheckMate-227, a large controlled phase III clinical trial, showed that among the PD-L1≥1% of non-small cell lung cancer patients, the median survival time of in the O+Y dual-immune combination treatment group was 17.1 months, and 14.9 months in the chemotherapy group; the 2-year survival rate was 40%, and 32.8% in the chemotherapy group; the median sustained remission time was 23.2 months, and the chemotherapy group was only 6.2 months in .
▲Photo source: Reference source[1]
At the 2021 American Society of Clinical Oncology Annual Meeting (ASCO In 2021), the researchers updated the 4-year follow-up results of CheckMate-227: among patients with
- PD-L1≥1%, the -year survival rate in the O+Y dual-immune combination treatment group was 29%, 21%, and 18% in the chemotherapy group; among patients with
- PD-L1≥50%, the -year survival rate in the O+Y dual-immune combination treatment group was 37%, and the chemotherapy group was 26% ; among patients with
- PD-L1 <1%, the -year survival rate in the O+Y dual-immune combination treatment group was 24%, 13%, and 10% in the chemotherapy group.
▲Photo source: Reference source: [3] The dual immune combination therapy of
O+Y has brought new treatment hope to lung cancer patients, significantly prolonged the survival of lung cancer patients, and has become an important first-line treatment plan for advanced non-small cell lung cancer.
triple combination therapy extends the survival time of lung cancer for nearly 5 months
In addition, researchers also pointed out that the triple combination therapy of "O drug + Y drug + two-cycle chemotherapy" also has outstanding performance for the first-line treatment of non-small cell lung cancer without EGFR or ALK driver gene mutations. This combination therapy has also been approved by the US FDA for to be launched on .
In 2021, published in the authoritative medical journal Journal of Clinical Oncology, the results of the two-year follow-up of the CheckMate-9LA study showed that compared with assimilation, the triple regimen significantly extended the patient's median survival (15.8 months vs 11 months) and median progression-free survival (6.7 months vs 5.3 months) and improved the survival (2-year survival rate: 38% vs 26%). And whether PD-L1 is negative or positive, whether it is squamous cell carcinoma or non-squamous cell carcinoma, you can benefit from it.
▲Photo source: Reference source [4]
"Dechemotherapy" treatment of lung cancer
As we all know, the side effects of long-term chemotherapy will accumulate, and the bone marrow suppression caused by the causes of some patients intolerant, and it also affects the quality of life and long-term survival opportunities. The launch of dual-immune combination therapy is especially good news for patients who are intolerant of chemotherapy or are unwilling to receive chemotherapy, which can avoid the harm of chemotherapy to the patient's body. Although
triple therapy has been added to chemotherapy, there are only two courses of treatment, which can avoid the accumulated side effects of long-term chemotherapy on the basis of enhancing the effect of immunotherapy on the basis of enhancing the effect of immunotherapy on the .
In short, both dual immunotherapy and triple combination therapy have brought new hope for the treatment of lung cancer patients and significantly prolonged the survival of lung cancer patients. I believe that with the in-depth exploration of researchers, more and more lung cancer patients will benefit from immunotherapy. If you want to know more about lung cancer treatment plans, you can contact the editor through comments or private messages.
Reference source:
[1]Nivolumab plus ipilimumab in advanced non-small-cell lung cancer. N Engl J Med. 2019;381(21):2020-2031.
[2]FDA approves nivolumab plus ipilimumab for first-line mNSCLC (PD-L1 tumor expression ≥1%)
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-nivolumab-plus-ipilimumab-first-line-mnsclc-pd-l1-tumor-expression-1
[3] Bristol Myers Squibb - Four-Year Data from Phase 3 CheckMate -227 Trial Show Durable, Long-Term Survival with Opdivo(nivolumab) Plus Yervoy (ipilimumab) in Patients with Non-Small Cell Lung Cancer with PD-L1 Expression ≥1%
https://news.bms.com/news/details/2021/Four-Year-Data-from-Phase-3-CheckMate--227-Trial-Show-Durable-Long-Term-Survival-with-Opdivonivolumab-Plus-Yervoy-ipilimumab-in-Patients-with-Non-Small-Cell-Lung-Cancer-with-PD-L1-Expression-1/default.aspx
[4]DOI: 10.1200/JCO.2021.39.15_suppl.9000 Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021) 9000-9000.
