This is a breakthrough: many patients with breast or lung cancer can avoid chemotherapy and its serious side effects, according to studies that should change the way cancers are treated.
The first good news is for women who have had breast cancer. Up to 70% of them can avoid chemotherapy, depending on the results of an existing genetic test, and be treated with hormonal drugs usually prescribed after an operation to remove the tumor.
Tumor analyzed genetically
As for lung cancer, studies also presented at the big annual cancer conference in Chicago (ASCO) show a new era where patients will see their tumors analyzed genetically. If certain mutations are detected, a tumor-specific drug may be prescribed.
Otherwise, in most cases, the patient will be able to receive a new type of treatment, such as immunotherapy. The majority of patients would therefore avoid nausea, hair loss and other side effects caused by highly toxic chemotherapy.
Thanks to a succession of clinical trials, the entire lung cancer treatment model has been turned upside down, an “extraordinary” change, according to a specialist.
Currently, many women undergo chemotherapy after the surgical removal of the tumor, in addition to hormone therapy drugs, to prevent the eventual return of cancer.
But an international study on 10,000 women concluded that the level justifying the use of chemotherapy could be revised safely. For years, a genetic test performed on the tumor has predicted the probability of recurrence. This test gives a score between 0 and 100. Until now, chemotherapy was recommended above 25. Below 10, it was not. This posed a dilemma for women in the gray zone, between 11 and 25.
The study showed that for these women, after nine years of follow-up, chemotherapy did not bring anything.
For the most common type of lung cancer, it is immunotherapy that offers huge hope. Pharmaceutical companies are competing fiercely in this field.
At the conference, a study on the Keytruda, or pembrolizumab made big noise. The American company Merck, known as MSD abroad, has bet everything on it. It is taken intravenously, every three weeks, and has become the best-seller of the laboratory, especially against melanoma and lung cancer.
Immunotherapy drugs help the patient’s immune system do what it is supposed to do: detect and attack the tumor. The method does not work against all types of cancers and can cause serious side effects, sometimes to the point where patients stop treatment.
For the latest clinical trial, funded by MSD, the researchers compared the efficacy of taking Keytruda alone to chemotherapy (the effect of the combination of the two protocols was studied separately, and shows good results in some cases) . Patients first treated with pembrolizumab lived four to eight months longer than those who received only chemotherapy. Above all, they were less likely to suffer serious side effects (18% versus 41%).