Targeted Therapy for Non-Small Cell Lung Cancer

In March, the FDA issued approval for Bristol Meyers Squibb’s immunotherapy, Opdivo, in conjunction with chemotherapy and surgical procedures to treat non-small-cell cancer. Patients given this course of care had better outcomes after surgery and lived longer than those who received chemotherapy alone. During the phase three “Checkmate” clinical trial, Opdivo paired with chemotherapy and surgery resulted in a 24% pathological response rate which was 12 times better than chemotherapy alone.

The Bristol Meyers Squibb company markets Opdivo as an immunotherapy that activates T-cells by helping them find and eliminate cancer cells in the body. The drug’s approval for resectable non-small cell lung cancer (NSCLC) is the first to use pre-surgery immunotherapy-based treatments to handle early-stage cancer.

Immunotherapy is an old concept, but currently available treatments are complex tools in the fight against cancer. These drugs work by targeting T-cell inhibitors, thus increasing the T-cell activity and causing them to attack cancer cells that are growing in the body. When T-cells are unleashed in the body, they occaisonally attack the patient’s healthy cells in addition to the cancerous ones, leading to possible life-threatening side effects.

The use case for immunotherapy is specific to the patient and the stage of cancer they are suffering from. Drugs like Opdivo and others are only effective if cancer cells carry particular proteins. That often means one drug may only provide value to a treatment regimen for a specific part of the body.

The most effective way to treat lung cancer is through early detection and targeted treatment of the disease. When cancer is detected early, five-year survival rates can be improved by nearly 40%. Past studies have looked for the best methods of identifying cancer in the body, including regular X-rays or other radiological scans. Low-dose CT scans have been studied as one such method for screening and they were shown to improve outcomes compared to other scans by detecting the earliest stages of cancer.

At this time, 90% of lung cancer diagnoses come at late stages resulting in worse prognoses for patients. Advanced stage lung cancer is particularly deadly, and patients often suffer 5-year survival rates of 10–20%. Additionally, only 20% of lung cancer patients are suitable for surgery like those included in the Opdivo Checkmate study.

Doctors are forced to use different treatment methods when cancer is considered inoperable. Sometimes these treatments involve radiation or targeted therapy. Monoclonal antibodies are one class of targeted therapy that have been utilized effectively to treat lung cancers.

The treatment and diagnosis of lung cancer are improving rapidly with the introduction of new medicine, leading to improved survivorship and patient outcomes. Opdivo is now one of five immunotherapies used as immune checkpoint inhibitors for lung cancer. There are also more than a dozen targeted therapies available that affect and inhibit certain proteins found in cancer cells.