Combination Therapy Doubles Survival in Metastatic Lung Cancer

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Combination therapy doubles survival in metastatic lung cancer – an article from Science Daily.

The purpose of this article is to clarify the efficacy, or lack thereof, of checkpoint inhibitors by themselves, for cancer patients.

Across the board, approximately 20% of the treated population will have a positive response to these immunotherapy drugs. We are identifying subsets of patients that are more likely to respond, such as those who have tissue significantly expressing PD-L1, evidence of microsatellite instability (MSI), and high mutation burden.

Multiple studies have been published showing synergy between checkpoint inhibitors and the use of molecularly targeted drugs, chemotherapy, and radiation therapy. Intuitively, this makes sense, because when we kill some cancer cells with these other modalities, there will be more antigens released to theCD8+ T cells, which have been turned back on with the checkpoint inhibitors. In my practice, in patients with terminal diagnosis, I often combine checkpoint inhibitors with other modalities, regardless of the tissue of origin.

The major problem, however, is often financial, as the insurance companies are unlikely to cover the cost of immunotherapy if the checkpoint inhibitor is not approved for that specific cancer. Keep in mind that just because immunotherapy is not indicated for the patients’ diagnosis, does not mean that the patient can’t get the drug; it just means that the patient must pay out of pocket.

March 28th, 2019

Posted In: cancer care

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