Immunotherapy Also Found Effective in Small Cell Lung Cancer

Small cell lung cancer accounts for 15% of all lung cancers. In the locally advanced and early stages of this type of lung cancer, the most important treatment option is combined chemotherapy and radiotherapy. Metastatic disease is primarily treated with chemotherapy, with radiotherapy added later. A study in small cell lung cancer of immunotherapies whose effectiveness had been demonstrated in non-small cell lung cancer and which had entered use with FDA approval was presented at the ASCO 2018 Congress.

- Related topic: Immunotherapies and Cancer Vaccines

Phase-2 clinical trial KEYNOTE-158 enrolled 107 patients. All participants had small cell lung cancer that had recurred after chemotherapy. The immunotherapy pembrolizumab (Keytruda) was administered as the study treatment.

According to the study results:

• In 40% of patients, the PD-L1 test , which is associated with immunotherapy effectiveness, was positive.
• In PD-L1-positive patients, the rate of benefit from pembrolizumab was 36%, and the disease control rate was 43%.
• Among patients whose disease was controlled, 73% benefited from treatment for more than 1 year.
• In patients with a negative PD-L1 test, the rate of benefit from treatment was 6%.

For the treatment of small cell lung cancer, where the desired success has remained elusive for years, the study’s results are potentially groundbreaking . However, this study should be reassessed once detailed analyses with thorough evaluations of patient groups become available.

In small cell lung cancer, how long after completion of treatment the disease recurs is very important. This shows us the disease’s resistance to treatment. If disease recurs during or immediately after treatment, these treatments may not provide as much benefit as desired. Another point we need to know is the percentage of PD-L1 positivity. We know that, in lung cancer, the higher the percentage of PD-L1 staining in the tumor (especially 50% or above), the better the treatment response.

In conclusion, we consider this study a major step forward for small cell lung cancer. Nevertheless, we would like to reassess it for you when its detailed scientific article is published soon. 

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