Tag Archives: Keytruda

New drugs making progress against lung cancer

Lung cancer is one of the deadliest forms of cancer. At one time 90 percent of the people who developed lung cancer died from the disease. The number is better now, but the death rate for lung cancer is still one of the highest for any form of cancer.

The five-year survival rate today for lung cancer is still only about 17.7 percent and more than half the people who are diagnosed die within a year. However, early detection is key. Lung cancer is a bitch about metastasing to other parts of the body. If it can be caught early while still localized in the lung, the five-year survival rate jumps to 55 percent.

They haven’t found a cure, of course, but no drugs are making big progress on lung cancer, as well as prostate and breast cancers.

One of the main drugs used against a certain kind of lung cancer (that younger people and nonsmokers tend to get) is Xalkori, makde by Pfizer. This new drug is called Alecensa, made by Roche.

The AP did a big story on this last week. From the story:

“Roche’s Alecensa stopped cancer growth for 15 months longer than Pfizer’s Xalkori did in a study of 303 people with advanced lung cancer and a mutation in a gene called ALK. About 5 percent of lung cancer patients — 12,500 in the U.S. each year — have an ALK mutation, especially younger people and nonsmokers who get the disease.

Alecensa kept cancer from worsening for 26 months versus 11 months for Xalkori. It also penetrates the brain better: Only 9 percent of those on it had their lung cancer spread to the brain during the first year of treatment versus 41 percent of those on Xalkori. Serious side effects and deaths were less common with Alecensa.

The federal Food and Drug Administration approved it in December 2015 for ALK-related lung cancers that worsened despite trying Xalkori. The new study tested it as initial treatment and is aimed at getting full approval for that.

Xalkori is around $10,000 a month and Alecensa about $12,500.”

So, this drug extends the life of lung cancer patients by two years on the average.

Look at the price tag, though. Imagine trying to pay for that without medical coverage.

Obviously not a cure, but maybe making a dent in that terrible survival rate. Incredible with the advances in treating cancer, especially childhood leukemia, that they have made so little progress in treating lung cancer. I think that is partly because of the stigma that continues to surround lung cancer compared to other kinds of cancer.

Another promising front is immunotherapy with drugs such as Keytruda (this is an esperimental drug taken by Jimmy Carter when he was diagnosed with terminal brain cancer a few years ago and he’s still kicking). I’ve written about this before.

From a Medscape article:

The overall response rate (ORR) of 45% reported for pembrolizumab (Keytruda) first-line is unprecedented, Dr Soria said. Together with the superior progression-free survival (PFS) and overall survival (OS), as well as the better tolerability, when compared with chemotherapy, these findings indicate that pembrolizumab is now “the new gorilla” in the treatment of (non-small cell lung cancer), and probably a new standard of care, he said.

There was also good news on the breast cancer and prostate cancer fronts. A new drug called Zytiga delayed cancer growth for 18 months for men with advanced prostate cancer, while a drug called Lynparza helped delay breast cancer growth for seven months.

Jimmy Carter on the forefront of possible breakthrough in lung cancer drug

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Jimmy Carter was diagnosed about a year ago with advanced liver cancer that had metastasized into his brain and other organs. Usually, for a 90-year-old man, the prognosis is not good.

However, a year later, Carter is at the moment cancer-free and apparently has no plans of dying any time soon. Carter was given an experimental immunotherapy drug called Pembrolizumab (trade name Keytruda, which I’m going to use because it’s easier to spell), which worked wonders on his cancer.

Keytruda has also been shown to be effective in treating small-cell lung cancer, still one of the most difficult types of cancer to treat. Despite the dramatic drop in smoking rates the past 25 years, lung cancer remains the No. 1 cancer killer in the West.

Because Keytruda is working so well in treating lung cancer among 300 trial patients, the drug company Merck announced that it will no longer hold trials and will make Keytruda available to these lung cancer patients. According to Merck, Keytruda worked as well if not better than conventional chemotherapy and helped stopped the growth of lung cancer tumours.

From an NBC story:

The details are not available yet. “We look forward to sharing these data with the medical community and with regulatory authorities around the world,” said Dr. Roger Perlmutter, president, of Merck Research Laboratories.

Independent committees look at the details of the patients and how well they are doing in drug trials like these. It was one of these independent committees that recommended stopping the trial based on what they saw but that doesn’t necessarily mean they shared the details with the company or anyone else.

“I suspect the findings were significant enough that this will be a practice-changing finding,” Dr. Pasi Janne, lung cancer specialist at Harvard Medical School and the Dana-Farber Cancer Institute, told NBC News.

Keytruda has not been approved yet for wide use by the Food and Drug Administration, but the process of getting its approval has begun. Keytruda has been OK’d for patience for whom standard chemotherapy has failed. Merck is seeking its approval as a first-line drug for lung cancer. The FDA has been known to give quick approval to these kind of immunotherapy cancer drugs.

From NBC News:

They treat cancer by stopping tumor cells from cloaking themselves against the normal, healthy immune system response.

They work on the principle that it’s not where cancer starts that matters, but the genetic mutation that causes the cancer. So a lung tumor in one patient may look like the melanoma in another.

Keytruda — known generically as pembrolizumab — targets the activity of genes called PD-1 (anti-programmed-death-receptor-1) and PD-L1. The interaction between the two genes lets some tumors escape detection and destruction by immune system cells.

PD-1 stops immune cells from attacking normal healthy cells by mistake. Tumor cells make PD-L1 turn on PD-1 when immune cells approach.

This trial only included patients whose tumors cells made a lot of PD-L1. That is only a portion of people with lung cancer – 25 percent in one recent trial.

Immunotherapy is a whole new way of treating cancer, including lung cancer,” said Janne, who was not involved in the study. “Having seen patients benefit who failed existing therapies, now doing well on these new therapies, is fantastic.”

New drug uses body’s own immune system to fight lung cancer

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An interesting story from NBC News. A new drug, called Keytruda, can apparently use the body’s own immune system among some patients to fight both lung cancer and melanoma.

According to the NBC News article:

Garon’s team tested Keytruda in 495 lung cancer patients. The drug targets mutations in genes called PD-1 and PD-L1. These mutations let some tumors escape detection and destruction by immune system cells that normally prevent cancer from spreading in the body. … It worked in about 19 percent of the patients,

Before you think 19 percent is a petty amount — keep in mind lung cancer is the No. 1 cancer killer in the world. In the U.S., about 224,000 people a year get lung cancer. 19 percent of 224,000 is 43,000 people … a year … in the U.S. alone.

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Currently, about 160,000 people a year die of lung cancer each year. We’re talking about potentially cutting that number by 25 percent if this drug works as well as promised.

From the NBC story:

Most of the patients helped by Keytruda saw their cancer stop growing for about an average of a year, and some still haven’t had the cancer come back, Garon’s team said in their report, which was also published in the New England Journal of Medicine.

About a quarter of the lung cancer patients in the trial had a mutation in PD-L1, and the people helped most by the drug were more likely to have the mutation, the researchers found.

The drug, known generically as pembrolizumab, caused many side-effects, such as fatigue and rash. But so does chemotherapy for lung cancer.

Hope760

In a second study, researchers compared Keytruda to another immunotherapy drug called Yervoy in 830 patients with melanoma.

After a year, 74 percent of patients who received Keytruda every two weeks were alive. This dropped to 68 of those dosed every three weeks. To compare, 58 percent of patients who got Yervoy lived a year or longer, researchers reported.

It’s not a cure. Another one of many, many baby steps toward a cure to the Plague of the 20th Century.