A new treatment significantly improves survival in patients with non-small cell lung cancer

Dr. Margarita Majem Tarruella, a researcher from the Clinical Oncology Group at the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau, and an oncologist at the same hospital, has participated in two studies that have been published in the prestigious journal The New England Journal of Medicine and presented at the American Society of Clinical Oncology (ASCO) conference currently taking place in Chicago, United States.

On one hand, the results of the ADAURA clinical trial have revealed that adjuvant therapy with osimertinib, an inhibitor of the epidermal growth factor receptor (EGFR), has significantly prolonged overall survival in patients with early-stage non-small cell lung cancer with EGFR gene mutations.

The randomized, double-blind, phase III clinical trial analyzed data from 682 patients, of whom 339 received osimertinib and 343 received a placebo. Among patients with stage II to IIIA disease, the overall 5-year survival rate was 85% in the osimertinib group and 73% in the placebo group.

According to these data, adjuvant therapy with osimertinib has demonstrated a significant benefit in overall survival among patients with non-small cell lung cancer with EGFR gene mutations.

These results offer new hope for patients in the early stages of the disease, as they represent the largest reduction in mortality ever recorded in the field of lung cancer and highlight how targeted therapies against tumor alterations are driving oncology towards more effective treatments for specific groups of patients.

EGFR alterations are the most common type of mutation in lung tumors in non-smokers, while they are not as frequent in people who have smoked, as detailed by Dr. Majem.

“This is the first time we have seen such a magnitude of improvement in lung cancer survival, and we believe it is a very hopeful outcome that will translate into an improved prognosis for these patients.”

Combination of immunotherapy before and after surgery

On the other hand, another study in which Dr. Majem participated concluded that patients with early-stage non-small cell lung cancer who are candidates for surgery and receive neoadjuvant treatment with pembrolizumab in combination with chemotherapy followed by surgical resection and adjuvant treatment with pembrolizumab show a better therapeutic response and longer progression-free survival compared to conventional treatment, which consists of neoadjuvant chemotherapy followed by surgery.

This is a randomized, double-blind clinical trial called KEYNOTE-671, which analyzed follow-up data from 797 patients over 25.2 months. The results showed that the 24-month progression-free survival rate was 62.4% in the pembrolizumab-treated group compared to 40.6% in the placebo group. Additionally, a greater pathological response was observed in 30.2% of participants in the pembrolizumab group compared to 11.0% in the placebo group.

According to Dr. Majem, “these results provide a new perspective on the treatment of early-stage lung cancer and could have a significant impact on how this disease is approached in the future.”

Reference articles

  • Tsuboi M, Herbst RS, John T, Kato T, Majem M, Grohé C, Wang J, Goldman JW, Lu S, El seu WC, de Marinis F, Shepherd FA, Lee KH, NT, Dechaphunkul A, Kowalski D, Poole L, Bolanos A, Rukazenkov I, Wu YL; ADAURA Investigators. Overall Survival with Osimertinib in Resected EGFR-Mutated NSCLC. N Engl J Med. 2023 Jun 4. doi: 10.1056/NEJMoa2304594. Epub ahead of print. PMID: 37272535.
  • Wakelee H, Liberman M, Kato T, Tsuboi M, Lee SH, Gao S, Chen KN, Dooms C, Majem M, Eigendorff E, Martinengo GL, Bylicki O, Rodríguez-Abreu D, Chaft JE, Novell S, Yang J , Keller SM, Samkari A, Spicer JD; KEYNOTE-671 Investigators. Perioperative Pembrolizumab per Early-Stage Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Jun 3. doi: 10.1056/NEJMoa2302983. Epub ahead of print. PMID: 37272513.

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