An international study, significantly shaped by Greek oncology, has unveiled a promising new treatment for small cell lung cancer (SCLC).
Presented at the prestigious American Society of Clinical Oncology (ASCO) annual conference in Chicago and simultaneously published in The New England Journal of Medicine, this research offers a beacon of hope for a disease that has seen little progress in three decades.
SCLC accounts for approximately one in five lung cancer cases and is strongly linked to smoking. Unfortunately, it exhibits the most aggressive biological behavior among lung cancer types.
Dr. Ioannis Mountzios, a pathologist, oncologist, and director of the 4th Oncology Clinic and Clinical Studies Unit at Henri Dunant Hospital, served as the first author of this pivotal study and delivered the announcement at the world’s leading oncology conference. As Mountzios explained, the term “small cell” refers to the microscopic appearance of the cancer cells.
Shifting the paradigm for relapsed small cell lung cancer
For thirty years, chemotherapy was the primary weapon against SCLC, with immunotherapy being a very recent addition. However, treatment options for patients who relapsed after initial chemotherapy and immunotherapy were extremely limited, offering mediocre results and an average survival of only around eight months post-relapse. The grim reality was an average survival time of only twelve to thirteen months from diagnosis for SCLC patients.
“The hopeful message we bring today,” stated Mountzios, “is the emergence of a new form of immunotherapy that operates in a unique way.” This innovative treatment essentially brings the cancer cell and the patient’s immune cell together, enabling the immune system to recognize and attack the cancer.
40 percent reduced risk of death
This groundbreaking immunotherapy was rigorously tested in a global clinical study involving over eighty centers worldwide and more than 500 patients.
The study compared this new immunotherapy to standard second-line chemotherapy and demonstrated a remarkable 40 percent reduction in the risk of death for patients receiving the novel treatment. This means patients undergoing the new immunotherapy have a significantly lower chance of mortality compared to those on classic chemotherapy.
While a complete cure for extensive and recurrent SCLC remains challenging, the clinical study observed encouraging instances of prolonged survival, exceeding one and even two years on average, even in the second-line setting.
Mountzios noted that “average means that some of these patients may have a much longer survival, depending on the specifics of each one.” The potential for a “functional cure” in some cases is a prospect that time will further illuminate.
Furthermore, this new immunotherapy was associated with clinically significant improvements in bothersome symptoms like shortness of breath and cough. Patients also experienced fewer serious adverse effects and treatment interruptions, leading to a noticeably better quality of life.
Administration and side effects of the treatment
The new immunotherapy is administered intravenously, with an initial induction phase of weekly infusions for three weeks (days 1, 8, and 15), followed by infusions every two weeks for as long as the patient benefits.
A key advantage is its lighter side effect profile compared to traditional chemotherapy. “It is not chemotherapy with all that this entails,” Mountzios clarified.
“Therefore, it does not cause hair loss, it does not lower blood counts (hematocrit, white blood cells, platelets), and it lacks most of the classic side effects we associate with chemotherapy.” However, due to its immune-activating mechanism, a small percentage of patients may experience an excessive inflammatory reaction, leading to a high fever that requires monitoring of blood pressure, heart function, and breathing.
Greek oncology’s global impact
This study underscores the capacity of Greek oncology to participate and excel in large-scale global clinical studies, rivaling even traditional international powerhouses.
“Small countries like our homeland can contribute substantially to these global research efforts,” Mountzios emphasized. The study paves the way for new immunotherapy drugs in SCLC, with ongoing trials already active in Greece.
For Mountzios, this announcement signifies a profound personal achievement. He explains:
“It means a recognition of the effort and value of a Greek oncologist who lives and works in Greece and not abroad, because here the difficulties and challenges are even greater. I feel truly blessed and lucky to have been able to contribute to the global effort to alleviate human suffering from lung cancer.”
(With information from AMNA)
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