the drug has achieved unprecedented results in patients with metastases

Medicine for patients with lung cancer subtype showed unprecedented results, according to a study presented this Friday at a major cancer convention in Chicago.

In this city in the USA there is an annual meeting American Society of Clinical Oncology (ASCO), the most important specialty in the whole world. One of the first sessions was dedicated to discussing advances in the field of metastatic non-small cell lung cancer (NSCLC).

Non-small cell lung cancer is the most common type of lung cancer, accounting for 85% to 90% of all cases. In turn, it has different subtypes depending on the cells affected, and can also be affected by certain genetic mutations.

The medicine in question is lorlatinib, which was launched in Argentina in 2020 as an alternative to chemotherapy. It is a daily pill and is the first biomarker-based therapy for patients with advanced ALK (anaplastic lymphoma kinase)-positive NSCLC who have not been treated with ALK inhibitors or have failed previous treatments.

He ALA is a gene which encodes an anaplastic lymphoma protein kinase that is involved in cell proliferation. When the ALK gene mutates, it fuses with another gene, EML4, to form what is called an oncogene, which produces a “failed” ALK protein, which cannot stop its growth promoting function.

The mutation of this gene is present in approximately 5% of patients and in half of the cases it appears in people under 50 years of age. More common in women and non-smokers.

Genetic tests on a tumor sample identify this mutation and reveal an alternative to targeted therapy to block the ALK protein, such as lorlatinib, developed by Pfizer.

The study, presented in the US and also published this Friday in the Journal of Clinical Oncology, was led by Benjamin Solomon, director of oncology at the Peter MacCallum Cancer Center in Melbourne, Australia. They followed 296 patients for five years: half received lorlatinib and the rest crizotinib, the first drug approved for the ALK gene in 2013.

Newest cure showed significantly better performance. Progression-free survival, which is the time a patient lives with the disease but does not worsen, was 60% for patients taking lorlatinib, compared with 8% for patients taking crizotinib, another ALA inhibitor from the same laboratory with which he was compared.

A very important finding was that in patients without brain metastases only four who took lorlatinib developed brain progression and this occurred within the first 16 months of treatment. This type of cancer is very aggressive, and 25 to 40% of people with ALK-positive NSCLC brain metastases develop in the first two years.

As a laboratory representative explained to AFP, this drug penetrates the blood-brain barrier better than previous generation drugs and acts by inhibiting tumor mutations that cause resistance.

“This is a very important indicator, because metastases to the brain the most dangerous relapse, so patients die. This drug has a neuroprotective mechanism, creates a “helmet” in the brain “It protects the central nervous system,” said Diego Caen, head of the department of clinical oncology at the Integral Cancer Center of Riojano and one of the Argentine doctors participating in the congress.

He is also one of the specialists who prescribes lorlatinib here. He says the private system usually covers it without issue, but the public system makes it more difficult to access. “We hope that these results promote its use as a first-line treatment for patients with this type of cancer,” he said.

According to the oncologist, 10 years ago patients with ALK-positive NSCLC died six months after diagnosis: today he has patients who They have been taking the pills for four years..

“The results of this study are one of the best examples that we are moving towards chronic cancer“, he emphasized. And although he clarified that this drug benefits a small percentage of patients, “the patient is 100% you.” The life that those who take this medicine lead, he assures, is absolutely normal, and its side effects the effects (such as increased cholesterol or triglyceride levels) are “quite manageable.”

After these five years of follow-up, patients treated with lorlatinib “still had not reached median progression-free survival, which is consistent with Longest progression-free survival reported in patients with NSCLC“, the researchers emphasized.

In addition to the long-term effectiveness in preventing progression in the brain and the fact that there were no new side effects,” “the results indicate unprecedented improvement in the results for patients with ALC + NSCLC,” concluded those responsible for the clinical trial.

In Argentina, lung cancer ranks third in incidence with more than 12,000 cases per year, but first in mortality: According to the latest data from the National Cancer Institute, 8,663 people die each year as of 2021. Most of them are men (5379 deaths).

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