Drug Harnesses Immune System To Combat Most Common Form of Lung Cancer

Stage 4 lung cancer

Recently approved immunotherapy drugs are offering patients – and their oncologists – new hope for extending survival of people with advanced non-small cell lung cancer (NSCLC). Lung cancer is the No. 1 cancer killer among both men and women. Together, squamous and non-squamous NSCLC represent 85 percent of lung cancer diagnoses.

On October 9, 2015, the immunotherapy drug, NivoluMAb (pronounced nye-vol-ue-mab, marketed as Opdivo) received expanded approval from the Food and Drug Administration (FDA) for patients with previously treated, metastatic non-squamous non-small cell lung cancer (NSCLC). With this approval, Opdivo is now an approved treatment option for previously treated, metastatic squamous and non-squamous NSCLC, regardless of PD-L1 expression.

Scientists estimate that at least half of all non-small cell lung cancer patients express PD-L1. The molecule disables or kills attacking immune cells when they contact the cancer cells, helping the tumor survive and grow. NivoluMAb is designed to reverse this effect and so the immune system can prevent cancerous tumor growth.

“More targeted treatments like NivoluMAb — where we match a patient’s unique tumor characteristics with a drug designed specifically to address those characteristics — are needed if we are going to improve the outcome for patients with lung cancer,” says David Carbone, director of the OSUCCC – James Thoracic Oncology Center. Carbone served on the international study steering committee of this Bristol-Myers Squibb-sponsored study. Carbone also served as chair of the steering committee for the study comparing NivoluMAb to chemotherapy in first line lung cancer.

The OSUCCC – James conducted a trial comparing NivoluMAb to standard chemotherapy for newly diagnosed/untreated patients and investigators have seen some encouraging results, even in patients who have never received chemotherapy. The trial is now closed to patient accrual, but other trials of lung cancer immunotherapy drugs are underway or pending at the OSUCCC – James.

Patient Benefiting From Local NivoluMAb Research

Rick Martin, 63, of Ironton, Ohio, making his normal 4 a.m. commute to his job as a crane operator when a severe headache caused him to instead steer his car to the emergency department. Imaging tests revealed a surprising diagnosis: Martin had six brain tumors. A local neurologist referred him to the OSUCCC – James, where further testing confirmed that he had stage 4 lung cancer that had spread to his brain, bones, liver and adrenal glands.

“I was shocked but I also knew I had to move on and stay hopeful, so I did,” Martin recalls, who celebrated his 63rd birthday Sunday, Oct. 25, 2015.

Martin had surgery to address the largest of his brain tumors and then completed a course of targeted radiation treatments, which has slowed the growth of his cancer. In February 2015, Martin elected to enroll in a clinical trial that would allow him to receive the NivoluMAb as a first-line therapy to address his primary, stage 4 lung cancer.

Now eight months into treatment, he has seen reassuring results: his tumors have stopped growing and are beginning to shrink.

“I’m doing great. For now, my tumors have stopped growing and the therapy (NivoluMAb) doesn’t make me feel sick or weak,” says Martin, who makes the 2 ½ hour trip to Columbus for treatment on the clinical trial every two weeks. “I’m able to maintain my small family farm – we have six cows, a beautiful paint horse and three miniature horses – and enjoy time with my wife, Norma.”

Combination Immunotherapy Trial Expected to Open Late 2015

Ohio State expects to open Checkmate-227 this fall, a new first line therapy study that will randomize patients to three different treatment arms: NivoluMAb alone, NivoluMAb plus a second immunotherapy drug called ipilimumab, or standard of care chemotherapy. The same drug combination (NivoluMAb and ipilimumab) has been shown to significantly increase progression-free survival in BRAF-mutated, previously untreated metastatic melanoma patients and resulted in FDA approval Oct. 1, 2015.

Read more about how immunotherapy in lung cancer is helping patients in this recent Columbus Dispatch article.