But trials over the last five years have repeatedly shown more uses for immune therapy in lung cancer, and the new research confirms that almost all lung cancer patients will now receive immune therapy, said Patrick Forde, the first author on one of the studies and a lung cancer specialist at Johns Hopkins Medical.
Lung cancer patients are to be given immunotherapy as the first line of treatment after clinical trials found that it boosted the immune system's ability to attack tumours.
One group of 400 patients received standard chemotherapy and the immunotherapy drug pembrolizumab, while a smaller group of patients received chemotherapy.
Researchers have found the drug Keytruda, when given along with standard chemotherapy, cut the risk of dying from the disease in half compared with chemo alone.
"It's pretty awesome times to have so many positive studies at once", added Matthew Hellmann, a lung cancer specialist at Memorial Sloan Kettering Cancer Center, who led one of the studies. Four immunotherapy drugs for cancer, known as checkpoint inhibitors, have been approved. According to the recently obtained finings, the medical experts suggest a new way to be used in treating lung cancer.
Keytruda was approved previous year as an initial treatment with chemo for the most common form of advanced lung cancer, but doctors have been leery to use it because that was based on a small study that did not show whether it prolongs life.
Rates of serious side effects were similar, but twice as many in the Keytruda group dropped out because of them. Roughly 20% of patients see their tumors respond when they get chemotherapy before surgery; in this study, among patients who received Opdivo instead, 45% of tumors had regressed and in three patients there was no remaining tumor at all, Forde said.
"We have a tool that helps us determine who are the patients that are most likely to benefit from this combination", Hellmann said. The immunotherapy drugs did not help people with fewer tumor gene flaws.
And for those with neither a lot of mutations nor a lot of immune cells, chemotherapy plus Keytruda seems to be the best choice, he said.
All of these immune therapy treatments worked for only about half of patients, but that's far better than chemo has done in the past. The median overall survival was 11.3 months in those who did not receive immunotherapy, whereas survival in the immunotherapy group was longer and the median has not yet been reached.
The estimated survival at 12 months was 69.2 percent in the group that received immunotherapy, and 49.4 percent in those who did not.