2023-08-22 12:31:59
The Atezo-Brain study, promoted by the Spanish Lung Cancer Group (GECP), has confirmed the benefit of simultaneously attacking lung cancer cases with asymptomatic brain metastasis detected at the time of diagnosis and immunotherapy. as the first treatment option.
X-ray of a lung with a tumor. EFE
More than 40% of patients with advanced stage IV lung cancer experienced reduction of systemic and brain disease, and brain metastases remained stable, without progression, for nearly seven months, more than double that with conventional treatment.
These results of the phase II clinical trial have been published in the scientific journal “Journal of Clinical Oncology” and have included the participation of 40 patients from eleven hospital centers throughout Spain, including the Bellvitge Biomedical Research Institute (IDIBELL ), the Catalan Institute of Oncology (ICO) and the Bellvitge Hospital.
According to the GECP, coordinator of the research, this is “an important advance in the fight against lung cancer with brain metastases that has been achieved thanks to an innovative therapeutic approach” with the monoclonal antibody atezolizumab, an immunotherapy drug that stimulates the immune system to attack cancer cells, along with chemotherapy.
“The combination of chemotherapy and immunotherapy has shown its efficacy both in the lung and in the brain, allowing us to postpone the use of brain radiotherapy and maintain a comprehensive therapeutic approach,” explains Dr. oncologist Ernest Nadal, director of the ICO Thoracic Tumor Program, principal investigator and member of the GECP.
Paradigm shift in the approach to lung cancer with brain metastases
This strategy represents a paradigm shift in the treatment of a group of patients that, generally, had been excluded from immunotherapy clinical trials, especially when they had not received previous brain radiotherapy or when they were receiving corticosteroids to control the neurological symptoms associated with the brain metastases.
Lung cancer patients presenting with brain metastases typically underwent cranial radiation therapy before initiating chemotherapy, often resulting in a delay in systemic treatment and negative effects on neurological function.
However, this new therapeutic approach has shown promising results by targeting both areas simultaneously from the start, says the GECP.
“Initiating chemo-immunotherapy in patients with lung cancer and brain metastases without clinical deterioration allows postponing whole brain radiotherapy, which could preserve neurocognitive function,” says the specialist.
The patients, all with advanced-stage (stage IV) lung cancer and previously untreated brain metastases, experienced a slowing of disease progression in 62% of cases within three months of treatment, both in brain metastases as in the lung.
In addition, brain metastases remained stable in half of the patients for a period of almost seven months, more than double the duration of conventional treatment.
To guarantee the quality and safety of the results, international criteria for monitoring brain metastases during treatment were used, and patients underwent neuropsychological evaluations to assess their cognitive function at all times.
The treatment turned out to be well tolerated and the pre-established limits of toxicity were not exceeded. The observed side effects were in line with expectations for chemotherapy and immunotherapy treatments.
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