A study carried out in Spanish hospitals has managed to consolidate a new standard of treatment for initial lung cancer that represents a 20% increase in survival and can benefit some 6,000 patients a year in Spain.
New England Journal of Medicine publishes the results of the NadimII assay. “It is not one more publication, nor one more drug. This is the confirmation of a different approach for patients with a type of tumor that represents 30% of lung cancers”, explains Mariano Provencio, principal investigator and president of the Spanish Lung Cancer Group (GECP) to La Vanguardia. .
The new scheme consists of the application of chemo-immunotherapy with nivolumab (a monoclonal antibody that binds to the PD-1 protein to help immune cells eliminate more cancer cells) before operating stage III tumors.
Currently, 30% of patients survive five years of treatment. With the new therapy, this percentage could rise to 70%, according to Provencio. The study shows that 36.8% of patients achieve a complete remission of the tumor, compared to 6.9% treated with chemotherapy alone. In addition, 85% of patients are alive at two years, compared to 63% survival provided by the traditional approach.
On the other hand, the new model makes it possible to operate on patients who were previously not considered operable, highlights the oncologist. 98% of patients in the combination therapy group underwent surgery after treatment, 24% more than participants enrolled in the control group.
“This new treatment modality based on chemotherapy plus immunotherapy is capable of completely making the tumor cells disappear, both from the tumor and from the metastases,” says Ernest Nadal, oncologist and researcher Ernest Nadal, member of the GECP board.
"This, which with chemotherapy was an anecdotal fact, is now achieved in 37% of patients: they have a very high chance of being completely cured," he continues. "Patients in whom the disease is not eradicated also achieve greater survival."
The GECP, made up of 620 multidisciplinary specialists from across the country, conducted the world's first research on the benefits of administering chemo-immunotherapy with novolumab before surgery, and nivolumab monotherapy after surgery.
The results of Nadim were spectacular, according to Provencio: "So much so that we captured international interest and a worldwide study was launched along these lines that validated Nadim's data and was key to the accelerated approval of the FDA (the health agency of United States) of this treatment”.
The National Institute for Health and Care Excellence, linked to the United Kingdom health department, has also expressed its favorable opinion, highlighting its cost effectiveness. The twenty Spanish centers that have participated in the study apply the new strategy in a standardized manner.
“This treatment has been well accepted as standard by the scientific community and I think it will spread across Europe soon,” says Dr. Provencio. “It requires that people know about it and that they change their mentality” regarding this “major paradigm shift in the approach to lung cancer”, the only advance that has occurred in the last ten years.
