World Lung Cancer Day: Illuminating Pathways of Progress
Lung cancer, the leading cause of cancer-related deaths worldwide, poses a tremendous burden on global health. As we commemorate World Lung Cancer Day, it is essential to shed light not only on this prevalent disease but also on the vast strides taken in the medical field to combat it. The Food and Drug Administration (FDA) has approved numerous drugs for treating lung cancer, each contributing to increased survival rates and improved quality of life for patients. Treatment choice often hinges on the type of lung cancer, its stage, the patient’s overall health, and specific genetic changes in the cancer cells. At TFS HealthScience, a leading oncology and hematology Contract Research Organization (CRO), we are proud to have been a part of many such advancements.
Chemotherapy continues to be a foundational aspect of lung cancer treatment. This form of therapy employs potent drugs, such as cisplatin, carboplatin, docetaxel, etoposide, and vinorelbine, which act by impeding the growth and division of cancer cells. Additional prominent chemotherapies include paclitaxel, often used in combination with carboplatin, and gemcitabine, which has demonstrated effectiveness both as a stand-alone treatment and when paired with cisplatin. Each of these drugs plays a vital role in current lung cancer treatment protocols, serving to slow disease progression and enhance patients’ quality of life.
In a landmark advancement on January 26, 2023, the FDA broadened the indication for pembrolizumab (Keytruda, Merck), a well-established immunotherapy agent. Now, it can be administered as an adjuvant treatment following surgical resection and platinum-based chemotherapy for patients with stage IB (T2a ≥4 cm), II, or IIIA non-small cell lung cancer (NSCLC). This move signals a critical expansion in therapeutic possibilities for lung cancer patients and illustrates the burgeoning synergy of immunotherapy and chemotherapy treatments, delivering a more comprehensive and effective approach to cancer management.
Targeted Therapy Drugs:
Targeted therapies have revolutionized the treatment landscape for lung cancer by addressing specific genetic mutations in cancer cells, inhibiting their growth and proliferation. Key categories of these targeted therapies include EGFR Inhibitors such as erlotinib (Tarceva), gefitinib (Iressa), and osimertinib (Tagrisso); ALK Inhibitors like crizotinib (Xalkori), ceritinib (Zykadia), and alectinib (Alecensa); and BRAF Inhibitors including dabrafenib (Tafinlar) and vemurafenib (Zelboraf).
In 2022, there were two significant FDA approvals of targeted therapy drugs for lung cancer, heralding a new era of treatment for specific patient populations. Enhertu (fam-trastuzumab deruxtecan-nxki), a novel drug targeting the previously untargetable HER2 mutation, offered hope to patients for whom there were no approved options beyond chemotherapy and immunotherapy. This approval followed results from the DESTINY-Lung02 trial, demonstrating that patients receiving Enhertu showed a robust and durable response to treatment.
Simultaneously, the FDA approved Krazati (adagrasib), providing an alternative for patients with KRAS G12C lung cancer mutation previously reliant on Lumakras (sotorasib). Approval for Krazati was based on the KRYSTAL-1 trial‘s results, demonstrating a high likelihood of response and prolonged duration of response for patients undergoing treatment. Both Enhertu and Krazati are reserved for patients who have already attempted at least one form of systemic treatment.
Immunotherapies represent a transformative approach to cancer treatment, harnessing the body’s immune system to recognize and combat cancer cells. Essential to this therapeutic arsenal are PD-1 Inhibitors, like Pembrolizumab (Keytruda) and Nivolumab (Opdivo), which block the PD-1 protein, facilitating an enhanced immune response to cancer. PD-L1 Inhibitors, such as Atezolizumab (Tecentriq) and Durvalumab (Imfinzi), also play a crucial role by blocking the PD-L1 protein, thus assisting the immune system in identifying and destroying cancer cells. Additionally, CTLA-4 Inhibitor Ipilimumab (Yervoy) works by obstructing the CTLA-4 protein, thereby promoting increased immune activity.
In 2022, the FDA provided additional approval for Libtayo (cemiplimab-rwlc), a PD-1 inhibitor, to be used in combination with chemotherapy for NSCLC patients at any point in their treatment journey. This approval, based on the promising results from Study16113, showcased improved outcomes for patients receiving the combined treatment regimen.
Similarly, the PD-1 inhibitor Opdivo (nivolumab) received an important label expansion, allowing its use in conjunction with platinum-based chemotherapy before surgery in early-stage NSCLC (IB-IIIA) patients, based on the results of the CHECKMATE-816 trial.
Furthermore, a new immunotherapy combination, Imjudo (tremelimumab) and Imfinzi (durvalumab), received FDA approval in 2022 for treating NSCLC in patients without ALK or EGFR mutations. This approval, rooted in the POSEIDON trial results, brought to the forefront a compelling therapeutic option that showed a higher likelihood of response and improved patient outcomes.
At TFS HealthScience, we understand that our responsibility goes beyond research. We are dedicated to increasing education about lung cancer, its prevention, and treatment options. We also recognize the importance of patient support. We endeavor to ensure that patients and their families receive the necessary guidance, understanding the complexities of diagnoses, treatments, and the emotional challenges cancer often presents. Our vision at TFS HealthScience extends into the future. We are continually evolving, broadening our knowledge base, and refining our methodologies. We embrace advancements in personalized medicine, particularly in the field of immuno-oncology. Our aim is to leverage our expertise in hematology and oncology, and the power of research, to contribute to the development of cutting-edge treatments for lung cancer and other malignancies.
As we mark World Lung Cancer Day, we, at TFS HealthScience, reaffirm our commitment to improving patients’ lives worldwide. We stand with every patient, researcher, and healthcare professional in the fight against lung cancer. Through our efforts in research, education, and patient support, we hope to play a significant role in the ongoing quest to conquer this formidable disease.