increasingly promising results against cancer
Immunotherapy, unlike chemotherapy or radiotherapy which directly attack tumor cells, is a treatment that stimulates the patient’s own immune cells so that they learn, or relearn, to recognize and destroy tumor cells.
Immunotherapy has experienced significant growth in oncology since the 2010s and has new hopes in the treatment of many cancers.
At the congress of the European Society of Medical Oncology (ESMO), which brought together the global oncology community from September 13 to 17 in Barcelona (Spain), these innovative therapies were at the heart of several studies with promising results. Example with four trials carried out using immunotherapies in the treatment of very aggressive cancers.
Advanced melanoma
In melanoma advanced, the results of a phase 2 trial of immunotherapy with anti-PD-1 treatment appear promising.
Concretely, tumor cells are capable of hijacking the immune system’s control mechanisms to avoid being destroyed.
They manage to trigger mechanisms that inactivate immune cells, notably T lymphocytes. These mechanisms called “checkpoints” can be blocked by treatments: immune checkpoint inhibitors. These help reactivate the immune system.
Example that concerns this study : “the binding of the PD-L1 protein, present on tumor cells, to the PD-1 receptor on the surface of T lymphocytes leads to the inactivation of the latter. By blocking the PD-1 receptor or the PD-L1 protein (with anti-PD-1 or anti-PD-L1), the inactivation of T lymphocytes is lifted. These immune cells will then be able to attack tumor cells again. specifies the National Cancer Institute.
Thanks to this treatment, a combination of two monoclonal antibodies, nivolumab combined with ipilimumab, the median overall survival was approximately 6 years in the CheckMate 067 trial.
“The results of this trial confirm the curative potential of immunotherapy in patients with advanced melanoma,” said Prof. Marco Donia, associate professor of clinical oncology at the National Cancer Immunotherapy Center of Denmark (Copenhagen Herlev University Hospital, Denmark), who was not involved in the study.
And even outside of clinical trials, immunotherapy has proven itself in routine clinical practice against advanced melanoma.
“Immunotherapy has transformed advanced melanoma from a previously fatal disease with a median survival of less than a year compared to what we see today: half of patients surviving for many years,” continues the doctor.
Bladder cancer
A study also showed good results regarding the management of invasive forms of bladder cancer (tumor invasion of the muscles of the bladder wall). Each year, 13,000 to 14,000 new patients are diagnosed, 4,000 of whom present with serious forms.
In these cancers, it is still the PDL-1 protein present on the tumor cell which binds to the PD-1 receptor present on the T lymphocyte (immune cell) and annihilates its ability to destroy the tumor cell.
In the Niagara phase 3 studypatients who received the combination of chemotherapy and immunotherapy saw the risks of recurrence and progression of the disease reduced by 32%, the risks of death at 2 years by 25%.
Triple negative breast cancer
This breast cancer is particularly difficult to treat because it does not have estrogen or progesterone receptors or even high levels of the HER2 protein, which are involved in the proliferation of cancer cells. Therefore, this cancer does not respond to hormonal therapy or anti-HER2 treatments.
The Keynote-522 phase 3 trial added, in patients withtriple negative breast cancer in early stages, the monoclonal antibody pembrolizumab PD-1 to platinum-containing chemotherapy.
“ Results showed a statistically significant and clinically meaningful improvement in overall survival with immunotherapy plus chemotherapy before surgery and continued immunotherapy after surgery; the five-year overall survival rate was 86.6% in patients who received immunotherapy and 81.2% in the placebo group. explains ESMO in a press release.
Metastatic “non-small cell” lung cancer
The Curie Institute presented the results of a phase 2 RELATIVITY-104 study which made it possible to evaluate the combination of two immunotherapies, nivolumab (anti-PD1 antibody) and relatlimab (anti-lag3 antibody which also contributes to prevent the destruction of cancer cells by T lymphocytes).
As a reminder, the main cause of death from cancer is lung cancer which affects 53,000 people per year in France. The most common form is so-called “non-small cell” cancer, often diagnosed at an advanced stage, when therapeutic options are limited.
The study results demonstrate the safety of the treatment, a reduction by almost half in the risk of relapse, and a benefit in terms of response rate and progression-free survival of the cancer.
“ In this sense, the positive results that we are presenting at ESMO foreshadow the immunotherapy of tomorrow and show us that we must continue this strategy of acting on several pathways of stimulation of the immune system. declared Professor Nicolas Girard (Institut Curie, France).
“ We will now launch the phase 3 study to evaluate this unique combination of immunotherapies in patients suffering from a common form of metastatic lung cancer, which affects more than 15,000 people per year in France.”
Gestational trophoblastic tumors
Gestational trophoblastic tumors – a tumor mass that develops from the placenta – are rare tumors seen in young women during pregnancy. The standard treatment for low-risk tumors is methotrexate, which already cured 70% of patients.
A French Trophamet clinical trial shows a 96% cure rate in women treated with the combination of methotrexate and an immunotherapy – the monoclonal antibody avelumab. 25 patients out of the 26 included in the trial were cured. For the scientists who conducted the study, this combination must become a new therapeutic standard.
