Spanish study changes paradigm of early treatment of lung cancer

A study by the Spanish Lung Cancer Group (GECP) confirmed a paradigm shift in the early stages of the approach to these tumors, without metastases, with a therapeutic strategy that increases the number of surgery candidates to 93% and in 36.8% of cases can cure tumors. Process.

The President of the GECP, Oncologist Mariano Provencio, will present the data of the NADIM II study at an oral session on June 5, as part of the annual meeting of the American Society of Clinical Oncology (ASCO, its acronym in English). That it is celebrated in Chicago, this year after a two-year pandemic in person.

“In Spain, we have managed to change the paradigm: this is not just another medicine, this is a new way of treatment, because we can operate on many more patients and get many more lives,” he said. Oncology department at Puerta de Hierro Hospital in Madrid for a press conference.

The NADIM II study, which involved 86 patients from different hospitals in Spain, tested a combination of chemotherapy and immunotherapy (a drug that stimulates the immune system against malignant cells) in a group of patients before surgery and compared it with other treatments treated with chemotherapy only but not all. Most developed in and localized lung tumors.

Improves prognosis and chance of cure

The oncologist provided us with the results of a study that shows that preoperative treatment reduces or eliminates the tumor and allows patients who were not previously candidates to undergo surgery, which improves prognosis and the possibility of cure.

In addition, it means creating a new strategy after 30 years without therapeutic innovations in the usual treatment of this early stage cancer, with chemotherapy and surgery when possible.

According to the study, 93% of those receiving a combination of chemotherapy and immunotherapy were allowed for surgery, compared with 69% of those treated with chemotherapy alone. In addition, 36.8% had no tumor at the time of surgery, which is called a complete pathological response, compared with 6% of those receiving chemotherapy alone.

As for the objective response rate (both reduction and disappearance of tumors), the data show 75% in combination therapy, compared with 48% in chemotherapy.

The Spanish lung cancer group was a pioneer in the world, in 2019, with a NADIM I study that tested this combination treatment on one group of patients before surgery and after three years the overall survival was over 80%, the data was published in the Journal of Clinical Oncology.

Without therapeutic innovations before this time and 30 years later, only 30% of patients in the early stages of this type of tumor survive for three years, so NADIM I shows a 50% increase in survival during this period, a percentage that NADIM II intends to confirm. When research progresses over time.

In addition, none of the patients who showed complete remission of the tumor experienced three years of follow-up with “so we can think we have cured them” with this new therapeutic strategy, according to Provence.

“NADIM I has created a great deal of excitement,” the oncologist said, and has opened the door to other international studies, such as the Checkmate 186 study, whose results are “consistent, albeit shorter” in patients with early stages. Compared to the GECP investigation.

This therapeutic strategy has already been approved by the FDA, the U.S. Drug Enforcement Administration. The specialist has shown his confidence that it will soon be authorized in Europe and Spain, although it is already being used for sympathetic use in patients with larger tumors.

One of the challenges, the GECP president said, would be to develop studies to better identify patients, as surgical intervention could be avoided in those whose tumor had completely disappeared with previous chemotherapy and immunotherapy, or additional approaches could be made after surgery. Without a complete pathological response.

Meanwhile, the GECP has launched the Real NADIM study to collect data from patients in clinical practice, following their evolutionary observations that reveal “excellent tolerance” to the side effects of combination therapy, which consists of only three cycles. An operation is underway.

Source: El Diario





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