Groundbreaking research presented by international leaders in lung cancer highlighted the benefits of focusing on the prevention of lung cancer, of spreading the message about the dangers of tobacco and of improving our regulatory process so unnecessary lives aren’t lost. Encouraging data about therapies to combat wasting and increase life expectancy were also shared at the at the 16th World Conference on Lung Cancer (WCLC) hosted by the International Association for the Study of Lung Cancer (IASLC), which also released a new statement on Tobacco Control and Smoking Cessation.
“Cancer is the No. 1 cause of cancer deaths globally with 1.6 million people diagnosed per year and 1.3 million deaths per year. Tobacco smoking is associated with 80 percent of all lung cancer, more so in men than in women. Thus, smoking prevention must have a very high priority in the global health care systems,” said Dr. Claudia Henschke, professor of Radiology and head of Lung and Cardiac Screening Program at Mount Sinai Medical Center, New York, as she introduced today’s press briefing at the WCLC.
To reinforce the national movement toward prevention, Henschke referenced a workshop held on Saturday at the WCLC that focused on the benefits of computed tomography (CT) scans to detect and prevent lung cancer.
“Lung cancer screening with low-dose CT scans has proven to reduce the lung cancer mortality by 20 percent, and all-cause mortality by about 7 percent in individuals aged 55-74 and with a previously-defined smoking history,” she said.
The U.S. Preventive Services Task Force recommends lung cancer screening for clinical care and the Centers for Medicare and Medicaid recently approved and implemented the practice in the U.S. health care system for a number of patients groups with clear risk factors. However, questions remain about the value of lung cancer screening with low-dose CT in never smokers and younger individuals.
New Tobacco Control and Smoking Cessation Statement
In an effort to combat the global dangers of tobacco, The IASLC’s new Statement on Tobacco Control and Smoking Cessation calls for higher taxes on tobacco products, comprehensive advertising and promotion bans of all tobacco products and product regulation including pack warnings. IASLC urges its members and others around the world to:
Implement the World Health Organization’s Framework Convention on Tobacco Control.
Adopt legal reforms that allow smokers and their families to use judicial systems to hold tobacco manufacturers accountable.
Support programs to prevent smoking initiation habits in children.
Implement tobacco cessation programs in clinics, hospitals and cancer centers.
Adopt policy measures that recognize the probable differences in the lung cancer risk of alternative nicotine delivery products.
Every hour lost to the cancer drug regulatory process costs 29 life-years in the U.S. and 260 life-years worldwide, according to research presented today by Dr. David Stewart, head, Division of Medical Oncology, University of Ottawa/The Ottawa Hospital. He presented data on how the regulatory process on new therapies slows progress by increasing drug developments costs. It also produces hindrances that delay approval of useful drugs.
Stewart and his team assessed cancer therapies undergoing phase III trials between 2001 and 2015. When the combined impact of all tumor sites and drugs were considered together, there were 29 life-years lost in North America per hour of delay in therapy approval (1 for every 2 minutes of delay) and 260 life-years lost worldwide per hour of delay (1 for every 14 seconds of delay). Stewart hoped his research would call attention to the impact of regulatory delays.
“Clearly, the survival gains associated with the [delayed] drugs are only modest,” Stewart said. ”However, there would be a large negative impact associated with approval delays even if factors such as co-morbidities, performance status, ability to pay, etc., limit the number of patients treated to a fraction of the total dying from a specific malignancy.”
Results from the ROMANA 1 and ROMANA 2 Phase III trial of anamorelin were presented by Dr. Philip Bonomi, Professor, Rush University Medical Center – Medical Oncology, Chicago, Ill. Bonomi and his team’s results showed that anamorelin effectively combats wasting and improves body weight and body mass in certain lung cancer patients.
Anamorelin is a novel, orally active, selective ghrelin receptor agonist that mimics the appetite-enhancing and anabolic effects of ghrelin. Cachexia is a debilitating condition often observed in patients with advanced non-small cell lung cancer (NSCLC). A decrease in body weight (BW), in particular loss of lean body mass (LBM), is a primary characteristic, and is associated with worsening functional status, quality of life and survival. Despite the high prevalence and substantial clinical impact of cachexia in patients with advanced cancer, limited therapeutic options exist.
“Loss of body weight and muscle mass have consistently been shown to be predictors of poor outcomes and shortened survival. To date, we have lacked effective therapies,” Dr. Bonomi said. “Now we have two randomized controlled trials that consistently demonstrate the positive impact of anamorelin in improving lean body mass and anorexia symptoms for people with advanced NSCLC and cachexia.”
Survival improved for patients who maintained or gained LBM versus patients who lost LBM. Anamorelin-treated patients also significantly gained body weight and had significantly improved anorexia-cachexia symptoms compared with placebo-treated patients, in ROMANA 1 and 2, respectively.
Wrapping up the briefing, French researchers reported that adding the angiogenesis inhibitor bevacizumab to standard treatment for malignant pleural mesothelioma (MPM) increases life expectancy without severe toxicity.
The French multicenter randomized phase 3 trial data was presented by Dr. Arnaud Scherpereel, Clinical Director in Pneumo-Immuno-Allergy Service and Professor at University Hospital Calmette Tonnel Lille, France.
Pleural mesothelioma affects the tissue that surrounds the lungs, and often causes chest pain under the rib cage, painful coughing, shortness of breath, unusual lumps of tissue under the chest and unexplained weight loss. Between 2008 and 2014, 73 centers enrolled 448 patients in the study. One group received standard therapy for MPM and the second group received standard therapy and bevacizumab. Scherpereel and colleagues found that the addition of bevacizumab to standard chemotherapy increased the median overall survival to 18.8 months compared to 16 months with standard chemotherapy. The progression-free survival was also improved with bevacizumab.
“Bevacizumab addition to pemetrexed/cis-platin provides a significantly longer survival in patients with MPM, with acceptable toxicity, making this triplet a new treatment paradigm,” Scherpereel reported.