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First-line immunotherapy treatment can improve survival for subset of lung cancer patients

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Results of phase III global clinical trial show that 75 percent of stage IV lung cancer patients with both complex tumor mutations and PDL-1 positive status respond to nivolumab.

Findings from a phase III clinical trial for advanced lung cancer patients could help oncologists better predict which patients are likely to receive the most benefit from immunotherapy as a first-line treatment based on the unique molecular characteristics of their tumor, according to a new study reported by a global team led by David Carbone, MD, PhD, of The Ohio State University Comprehensive Cancer — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC — James).

In this study, researchers compared the effectiveness of the immunotherapy drug nivolumab (pronounced “nye VOL ue mab,” marketed at Opdivo), with standard-of-care chemotherapy in 541 patients with previously untreated or recurrent non-small cell lung cancer (NSCLC) that expressed PDL-1 antibodies.

Nivolumab is part of a class of immunotherapy drugs known as PD-1 blocking antibodies. These drugs work by targeting the PDL-1 receptor — a known immunotherapy biomarker for lung and other cancers — to boost immune responses to the cancer.

Patients were randomized to receive either immunotherapy or standard-of-care chemotherapy. About 60 percent of patients treated on the trial ultimately crossed over to the immunotherapy treatment arm due to disease progression.

Results from this new study showed that nivolumab did not result in longer progression-free survival compared with chemotherapy in the overall population. The response rate for patients receiving nivolumab was 26.1 percent, with a 12.1 month median duration of response before disease progression. The response rate for patients treated on the chemotherapy arm was 33.5 percent, but median duration of response was just 5.7 months before disease progression.

“The good news is that we discovered that a subset of patients who had both high tumor mutation burden and high PDL-1 positive status did experience a significant benefit from immunotherapy,” says Carbone.

Patients with both high tumor mutation burden and high PDL-1 positive status had a 75 percent response rate compared with a 16 percent response rate to immunotherapy among patients with low mutation burden and low PDL-1. These same two groups had 25 percent and 23 percent response rates, respectively, when treated with chemotherapy, showing that these markers were selective for immunotherapy.

Understanding a patient’s overall tumor burden through genomic testing, says Carbone, could help identify patients most likely to benefit from immunotherapy before therapy ever begins.

“This study is an important step toward understanding the impact of tumor mutation burden and PDL-1 in immunotherapy response. This data shows we should evaluate these two factors independently to most accurately define who will benefit from immunotherapy,” says Carbone.

The findings are reported in the June 22, 2017, issue of the New England Journal of Medicine.

Source: https://www.sciencedaily.com/releases/2017/06/170621190037.htm

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Know the Symptoms of Lung Diseases and Consume these Important Nutrients for Better Health

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Lung diseases need no introduction considering the air we breathe in. Chronic Obstructive Pulmonary Disease (COPD), a condition that damages the lung airways causes an array of symptoms like chest tightness, breathlessness, persistent cough and wheezing. It has become one of the leading causes of mortality in the country.

Lung diseases have certain symptoms that should be taken care of, especially at night. Considering our breathing changes during sleep due to general muscle relaxation increasing airway resistance, it is imperative to recognize the symptoms of possible consequences.Immediate effects of night-time symptoms may include fatigue and low productivity, while the long term consequences may involve lung function changes, increased exacerbation frequency, cognitive effects, depression, impaired quality of life and worsening of cardiovascular diseases. Several studies have suggested that night time-symptoms may be the marker for the emergence of severe condition with more risk for an exacerbation.

Your diet plays an important role in maintaining your health, especially respiratory system. Eat foods that will help strengthen your lungs and prevent any possible diseases. We list down some foods that may help strengthen your respiratory system-

1. Vitamin E

Vitamin E helps create a defense mechanism against injury to human tissues and further help in building a stronger immunity. Vitamin E may include dry fruits like almonds, fish and herbs including oregano, basil, parsley and cloves.

2. Beta-Carotene

Beta carotene is full of antioxidants and plays a key role in controlling inflammation. Foods like green leafy vegetables, pumpkins, spinach, carrots, radish, broccoli and coriander are rich in Beta-carotene.

3. Magnesium Rich Foods

Magnesium helps boost the natural defenses and relaxes your lungs from the excessive pressure. Some of the magnesium rich foods are nuts, seeds, legumes, spinach, yogurt, figs, avocado and figs among others.

4. Vitamin C

Vitamin C is one of the most important antioxidants that have the ability to repair and promote tissue growth. This vitamin is present throughout the body and eradicates the effects of free radicals. Foods like dark leafy vegetables, berries, bell peppers and tomatoes are rich in vitamin C.


Source: http://food.ndtv.com/food-drinks/know-the-symptoms-of-lung-diseases-and-consume-these-important-nutrients-for-respiratory-health-1740648

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