At the annual American Association of Cancer Research (AACR) conference, scientists presented new research on what they called “The New Frontier in Lung Cancer” – immunotherapy combinations.

The Big Question: Do Combinations Work?

If we take the new immunotherapy drugs (like Keytruda, Opdivo, or Tecentriq) that have shown positive results for some people with advanced non-small cell lung cancer (NSCLC) and combine them with another treatment, does the combination work even better? For example, can you add one of those drugs to another therapy and improve patient outcomes even more?

In many cases, the answer seems to be yes.

Immunotherapy + Chemotherapy

The strongest data came from a trial studying Keytruda (pembrolizumab) added to chemotherapy compared to chemotherapy alone.  Results showed that the combination was better. In patients with nonsquamous NSCLC that had spread, more patients (69.2%) were alive after a year of taking the combination compared to those taking chemotherapy alone (49.4%). The average survival time of the two groups cannot be compared yet because too many patients are still successfully taking the combination treatment (this is good news!). The combination also allowed patients to stay on the drugs longer before the cancer progressed without significantly more side effects.

It is important to note that patients with EGFR and ALK changes in their cancer were not included in this study. Immunotherapy has not been the best treatment choice for them in the past. That being said, another study presented showed that these patients may receive benefits when Avastin (bevacizumab), is added to chemotherapy and the immunotherapy Tecentriq (atezolizumab). More work needs to be done, but it provides an interesting possibility for treatment of patients with the EGFR and ALK mutations after their cancer becomes resistant to targeted therapy.

Immunotherapy + Immunotherapy

Another study presented tested a combination of two immunotherapies: Opdivo (nivolumab) and Yervoy (ipilumumab). While survival data was not available yet, patients with a high tumor mutational burden (TMB) were able to stay on the combination significantly longer without cancer progression (7.2 months) than patients taking chemotherapy alone (5.4 months). TMB is being studied as a biomarker to help make decisions about who will respond to immunotherapy treatments.

Taken together, immunotherapy combination treatments showed positive results for the lung cancer community. The science is moving fast in this area and we expect to see more progress soon.

Other Advancements

Some other important advances presented at AACR include:

  • A new targeted inhibitor for the RET mutation showed strong Phase 1 clinical trial results. Patients with this mutation may want to enroll in a clinical trial to access some of the promising new targeted therapies.
  • A study showed that two doses of Opdivo given before surgery was able to reduce the cancer. This paves the path for clinical trials testing the benefits of immunotherapy in earlier stage cancers.
  • A new targeted therapy for ALK, lorlatinib, had good results in a Phase II trial for patients with lung cancer who are resistant to other ALK inhibitors, including those with the difficult-to-treat G1202R ALK change.

Your Best Care

As always, we cannot stress enough the importance of considering molecular testing (also known as biomarker testing) as well as clinical trials to determine your best treatment options no matter where you are in your lung cancer journey. Talk with your cancer treatment team about molecular testing, clinical trials, immunotherapy and combination treatment options that may make sense for you.

For questions, call our Treatment and Trial Specialists at 1-800-298-2436 or use the “Lung Cancer Questions” tab on the right of your screen.