Immunotherapy Drugs Show Major Progress in Early-Stage Cancer

Mint

01-06-2025

(Bloomberg) -- Drugs that boost the body's immune system to fight disease are showing promise in treating a variety of cancers in earlier stages, a development primed to expand their use and transform care for stubborn diseases like gastric and colon cancer.
Immunotherapy treatments such as Opdivo from Bristol Myers Squibb Co., Imfinzi from AstraZeneca PLC, and Roche Holding AG's Tecentriq have become bestsellers by increasing survival times in a number of advanced cancers.
Now the treatments are showing success against early and mid-stage cancers, according to results of large trials being presented at the American Society of Clinical Oncology meeting in Chicago this weekend. One highlight is that the drugs are preventing recurrences in operable tumors that are at high risk of relapsing.
'We're learning that immunotherapy may, in fact, be more effective when you have less of a tumor burden,' said Jean Bourhis, an oncologist at Lausanne University Hospital in Switzerland, who led a study on patients with squamous cell carcinoma of the head and neck. 'The key is using it earlier.'
Treatment for that kind of head and neck cancer hasn't fundamentally changed in two decades. Use of Bristol's Opdivo in the study slashed the recurrence rate by nearly a quarter after three years when used after surgery to help prevent a relapse. This development could impact about 40% of people diagnosed with the disease, Bourhis said.
In a study sponsored by AstraZeneca, researchers found that using the firm's Imfinzi drug before and after surgery reduced the odds by 29% over a two-year period that a nasty type of operable gastric or gastroesophageal junction cancer would relapse or progress.
The development sets the stage for a new global standard of care for such cancers, which are particularly common in Asia, doctors said.
In a study on colon cancer, sponsored by the National Cancer Institute, oncologists found that adding Roche's Tecentriq to standard chemotherapy used after surgery significantly bolstered the number of patients who were alive and disease free after three years.
The finding represents a major advance in the field, the study's lead investigator said, and could help roughly 15% of patients with operable colon cancer that has spread to the lymph nodes.
'We have a real potential to cure many of these patients,' the investigator, Mayo Clinic oncologist Frank Sinicrope, said in an interview.
For the companies, expanding the use of immune drugs to earlier stage cancers may provide a new source of revenue to an aging group of blockbusters.
'This brings a commercial opportunity,' said Susan Galbraith, AstraZeneca's executive vice president for oncology research. The company has discussed with regulators the potential for the drug to get approved for the new use case, she said, declining to go into detail of where those talks stood.
Merck & Co.'s immunotherapy Keytruda, which is featured in multiple studies at ASCO, shows how lucrative treating disease early can be. It has become the world's best-selling medicine thanks in part to its use in early cancer. Of the drug's 41 approved uses, nine are now for early-stage disease.
Treating cancer early is 'where our growth is,' Dean Li, head of research at Merck, said Thursday at an investor conference. 'But it's not just economic growth. This is where you can cure patients.'
New immunotherapy results in head and neck cancer are poised to upend decades of medical practice. For patients with an aggressive form of head and neck cancer, the longstanding first-line treatment was to surgically remove the tumor and use chemotherapy and radiation to keep the disease at bay.
The Opdivo study showed that adding the drug to the standard of care cut the risk of cancer recurrence three years after treatment by 24%.
That finding comes on the heels of a successful head and neck study from Merck's rival Keytruda drug. In a big study presented in April, Keytruda reduced the risk of relapse when it was used both before and after surgery in head and neck patients. That potential new use is now under review by US regulators.
In AstraZeneca's study being presented at ASCO, using Imfinzi before and after surgery was able to increase the number of people alive without a recurrence or disease progression after two years to 67.4% from 58.5%.
'For patients facing a high risk of relapse, this brings new hope for long-term survival,' said Yelena Y. Janjigian, an oncologist at New York's Memorial Sloan Kettering Cancer Center, who was lead investigator on the study. 'It is a pretty big deal.'
Will Murray, a 52-year-old retired New York police detective, discovered he had a tumor at the junction of his esophagus and stomach in April 2022. It was operable, but he was at high risk of relapse. In an interview, he said the high death rate from this type of cancer terrified him.
But Murray received one of the last spots in the AstraZeneca study and got into the immunotherapy arm. His tumor started shrinking even before the surgery. And since the operation, it hasn't come back, although he did suffer thyroid deficiency, a side effect of immune therapy drugs.
Murray now has to eat carefully and can't sleep flat due to the stomach operation, but he can mostly live a normal life, including taking long walks and going on trips with his girlfriend. He credits the immunotherapy treatment trial for helping keep his tumors at bay.
'It saved my life,' Murray said.
--With assistance from Danielle Chaves.
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