Two combination therapies for lung cancer are released, significantly improving patient survival!

Lung cancer is broadly divided into two histological subtypes: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

These two main subtypes can be further divided into different subtypes
according to their different characteristics.
Now we know that many non-small cell lung cancers are caused by driver gene mutations, and this type of lung cancer is suitable for targeted therapy
.
In addition, immunotherapy is becoming more and more
widely used in the treatment of lung cancer.

This article is the original of Translational Medicine Network, please indicate the source for reprinting

Author: kope

Among the new drugs in non-immune oncology for non-small cell lung cancer, targeted therapy still dominates, 309 out of 376 new drugs, most of which are targeted TKIs, the development of new immunotherapies or combinations of immunotherapies and other therapies, there are many trials
in the field of lung cancer.
PD1, PD-L1, and CTLA4 are the main targets
of immune checkpoint inhibitors.
LXR, CD47, TIGIT and LAG3 inhibitors have also received a lot of attention
.

77% disease control rate

 01 

Recently, the results of early clinical trials of the potential "first-in-class" LXR small molecule agonist abequolixron in different types of lung cancer were announced, with an overall response rate (ORR) of 38% and a disease control rate (DCR) of 77%.

This candidate therapy is designed to activate the expression of tumor suppressor protein APOE to inhibit tumor angiogenesis, deplete myeloid-derived suppressor cells (MDSCs), activate cytotoxic T lymphocytes (CTLs), and enhance the anti-tumor immune response
.
The data published this time suggest that the combination of abequolixron with full-dose docetaxel is well tolerated and shows encouraging clinical activity, indicating that the candidate holds promise as an add-on therapy to standard therapy in patients who have received a large number of pre-existing patients
.

The ORR was 38% (n=13) and 77% of all evaluable patients, including 5 patients
who achieved partial response (PR).
In the 2/3-line NSCLC cohort, 4 of the 5 evaluable patients achieved PR and 2 achieved confirmed PR.

In the 2-line SCLC cohort, 1 of the 8 evaluable patients achieved PR and 5 had an optimal overall response of stable disease (SD).

Four patients did not progress
during the 24-week period.
The most common treatment associated adverse effects (TEAEs) were fatigue (12 cases), diarrhea and nausea (9 cases), decreased appetite (8 cases), and neutropenia and weight loss (7 cases).

Of these, 2 patients developed grade 4 neutropenia
.

Significantly improves treatment outcomes

 02 

Not long ago, a phase 2 study in the United States showed that for metastatic non-small cell lung cancer with high expression of PD-L1, compared with PD-1 drug Zimberelimab alone, adding Domvanalimab and Etrumadenant can significantly improve treatment outcomes and patient survival
.
Patients enrolled were required to be untreated patients with at least 50% PD-L1 expression; Patients with EGFR/ALK gene mutations were not enrolled, with a total of 50 patients
in each group.

Although PD-1 inhibitors improve outcomes in patients with PD-L1-expressing non-small cell lung cancer, less than half of patients benefit from PD-1 monotherapy in the medium to long term
.
Therefore, this study evaluated the effect
of adding the TIGIT monoclonal antibody Domvanalimab and the adenosine receptor antagonist Etrumadenant to the PD-1 monoclonal antibody Zimberelimab in patients with metastatic non-small cell lung cancer with high PD-L1 expression.
Common adverse effects treated by this combination therapy include fatigue, nausea, constipation, dyspnea, decreased appetite, and pneumonia, and more serious adverse effects above grade 3 include pneumonia and anaemia
.

Relentless exploration

 03 

With the improvement of molecular detection technology and drug accessibility, from the early era of platinum-based chemotherapy to the era of targeted therapy of EGFR inhibitors such as gefitinib, and now to the era of immunotherapy dominated by PD-1/PD-L1 immune checkpoint inhibitors, the emergence of various new drugs has greatly improved the prognosis of patients with advanced lung cancer, and lung cancer is moving towards individualized and precise treatment
at a high speed 。 The latest version of the NCCN Version 3 lung cancer guidelines in 2022 recommends the detection of conventional targets (EGFR, ALK, BRAF, KRAS, NTRK, ROS1), emerging targets (MET, RET, HER2) and immunotherapy target PD-L1 in lung cancer patients to better guide the precise individualized treatment
of lung cancer patients.

Some of the new targets of small cell lung cancer immunotherapy include CSF2, ANTXR, Cadherin, and macrophages
.
It is believed that the development of these new drugs in the field of lung cancer can bring more and better treatment options and long-term clinical benefits
to patients.
In the face of lung cancer, countless doctors have devoted great energy and have been unremitting in exploration, but there is still no way to change the situation of "the world's first death toll from lung cancer", with the development of more and more new drugs, and the emergence of new treatment options, lung cancer treatment chronic disease will also "shine into reality"
.

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for treatment options.
If you need health guidance, please go to a regular hospital
.