New cancer treatment offers hope for patients without options

A new cancer treatment may stop disease progression in patients who are resistant to immunotherapy, doctors have discovered.

Immunotherapy uses the immune system to target and kill cancer cells, and can save lives when other treatment options such as surgery, radiotherapy or chemotherapy have failed. However, it may not help all patients, and some tumors may develop to counteract it.

Now oncologists in the UK have discovered a two-pronged treatment – ​​immunotherapy combined with guadecitabine, a novel experimental drug – that can reverse cancer’s resistance to immunotherapy. They found that patients lived longer than expected to die after exhausting all treatment options.

The combination of pembrolizumab, an immunotherapy drug, and the next-generation DNA hypomethylating agent, guadecitabine, halted cancer progression in more than a third of patients enrolled in the initial phase 1 trial. The results have been published in the Journal for Immunotherapy. cancer,

Experts from the Cancer Research Institute and the Royal Marsden NHS Foundation Trust said the dual combination could become an effective new weapon against many forms of cancer.

The trial involved patients from the Royal Marsden and University College London Hospitals with lung, breast, prostate and bowel cancers.

Professor Johann de Bono, lead investigator of the study, said: “I think one of the most important things about this trial is that we used a lot of different methods to look for changes in the immune system, which strongly showing that it was being affected by the combination treatment.” , Told.

De Bono, Professor of Experimental Cancer Medicine at the Cancer Research Institute and a Consultant Medical Oncologist at Royal Marsden, said: “In the long term we hope that if these effects are confirmed in other patient groups and in future studies, guadecitabine will help reduce the risk of cancer.” And pembrolizumab may help combat some of the resistance to immunotherapy that we see in many types of cancer.”

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The study used pembrolizumab and guadecitabine to treat 34 cancer patients, of whom the tumors of 30 were analyzed for immune activity and cancer development. Every three weeks for three years, he was injected with guadecitabine for four consecutive days — and pembrolizumab on the first day of those days.

Pembrolizumab is an immune checkpoint inhibitor drug that has already been shown to be successful in the treatment of several types of cancer, including lung and skin cancer. However, tumors can develop resistance to it and some patients who initially benefit eventually become ill.

Leading the study, Dr Anna Minchom, a clinical scientist at the Cancer Research Institute and a consultant medical oncologist at Royal Marsden, said: “Immunotherapy has shown amazing promise in cancer care over the past decade, but it has not worked well. does become resistant in all cancers and cancers can often become resistant. This combination may be a way to target their cancer even after it has stopped responding to immunotherapy.”

Guadecitabine may help overcome this resistance, the doctors, researchers and scientists involved in the trial have discovered.

Of the 30 patients whose cancer activity was analyzed, the disease was stopped in its tracks, with no tumor progression for 24 weeks or longer for 37%. Three-fifths (60%) of the group were resistant to immunotherapy before the trial. Of those, nearly four in 10 (39%) did not get sick after taking the drug combination.

The new treatment seems to be particularly beneficial for patients with lung cancer. Of those resistant to immunotherapy, half had controlled their disease for 24 weeks or longer.

Alison Soden, 61, of Dorset, was diagnosed with lung cancer four years ago and told she had a year to live, but then received pembrolizumab for three years. He is now cancer free.

“I know there is a chance that my cancer could come back and develop resistance to treatment, so it is reassuring to know that there are ongoing research efforts aimed at reversing cancer resistance to immunotherapy, ” He said. “I hope this new experimental drug combination will eventually make it to the clinic and help people who have developed resistance to pembrolizumab.”

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