Innovational cancer treatments such as immunotherapy are offering new hope to patients.
Often these go in conjunction with more common approaches such as regular chemotherapy. But determining the best treatment combination isn’t always straightforward. Many patients spend valuable time on expensive therapies with serious side effects that are not effective against cancer. Now, a new discovery is ready to help. USC Norris Comprehensive Cancer Center researchers have identified a biomarker that indicates which patients with non-small cell lung cancer (NSCLC) will respond well to chemo-immunotherapy. The biomarker, known as CX3CR1, is expressed on T cells and can be detected with a simple blood test, six to nine weeks after a patient begins treatment.
Immunochemotherapy (ICI) has revolutionized the treatment of lung and other cancers, but it doesn’t work for all patients. For some, it can even trigger an autoimmune reaction characterized by life-threatening problems with the lungs, liver, kidneys, or other organs. Current pretreatment methods to determine which patients will benefit from ICI therapy; and that they will experience harmful side effects; and they often don’t always work properly. CX3CR1 is the best thing that could happen: a non-invasive “early” treatment biomarker. It can be measured when patients present for their first follow-up and imaging appointment, typically about two months after starting ICI.
The findings build on earlier work by the team in 2021, which found that CX3CR1 can be used to predict treatment response in NSCLC patients receiving immunotherapy alone. The biomarker may also be useful for other cancers and therapies, and could ultimately help doctors and patients determine the most effective cancer treatments while avoiding unnecessary side effects and invasive biopsies. Because ICI therapy targets a patient’s immune system, rather than the tumor itself, the newly discovered biomarker could have broad utility across multiple cancer types. On the side of therapy for this tumor, there is a second novelty.
A recent clinical trial showed that the drug combination cemiplimab (a monoclonal antibody that targets the PD-1 receptor) plus platinum-based chemotherapy can prolong survival in patients with advanced lung cancer compared with placebo plus platinum-based chemotherapy. Now an analysis indicates that cemiplimab plus platinum chemotherapy also affects quality of life compared to chemotherapy alone. The Phase 3 EMPOWER-Lung 3 study demonstrated that the addition of cemiplimab to platinum-based chemotherapy was associated with improved survival in patients with advanced non-small cell lung cancer compared with chemotherapy alone.
Because quality of life is also an important measure of treatment benefit, the researchers examined how cemiplimab plus the platinum-based drug affected symptoms compared with chemotherapy alone for patients enrolled in this study using specific questionnaires. Patients who received cemiplimab plus chemotherapy experienced significant improvements in pain, shortness of breath, constipation, nausea and vomiting compared with those who received placebo plus chemo alone. Patients enrolled in the cemiplimab arm also had a significant delay in clinically significant deterioration of symptoms including cough, hemoptysis and dysphagia.
Surely not definitevely curing lung cancer; but quality of life is the least that must be granted to patients waiting for healing.
- Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
Scientific references
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Makharadze T, Quek RWG et al. Cancer 2023; May 8 in press.
Gogishvili M, Melkadze T et al. Nat Med. 2022; 28(11):2374-80.
Yu Y, Zeng D et al. JAMA Netw Open. 2019 Jul; 2(7):e196879.