Cancer immunotherapy shows long-term promise in lung cancer

New, long-term results from a clinical trial presented at the 1st European Lung Cancer Conference jointly organized by the European Society for Medical Oncology (ESMO) and the International Association of the Study of Lung Cancer (IASLC) show that MAGE-A3 ASCI (Antigen-Specific Cancer Immunotherapeutic), an immune-boosting treatment for lung cancer patients, reduces the risk of relapse after surgery -- to the same extent as chemotherapy but without the side-effects of chemotherapy.

Prof. Johan Vansteenkiste from University Hospital Gasthuisberg in Belgium described the results after 44-months follow-up from a double-blind, placebo-controlled trial in 182 patients with non-small-cell lung cancer -- the most common form of the disease.

After complete surgical resection of the tumor, patients were randomly assigned to receive either placebo injections or injections of MAGE-A3 ASCI administered over 27 months (five given at three-week intervals followed by eight given once every three months). MAGE-A3 is a tumor-specific antigen, expressed in 35-50% of non-small-cell lung cancer, but not on normal cells.

"The aim is to help the body immune system to recognize the MAGE-A3 antigen and therefore eliminate the cancer cells that express MAGE-A3," explains Prof. Vansteenkiste. "In other words, it is a kind of treatment method that makes the body immune system specifically attack the lung cancer cells."

After 44 months, 69 of 182 patients had experienced a recurrence of their cancer, including 57 deaths. Those given the MAGE-A3 injections had longer on average before their cancer recurred, were less likely to have any recurrence, and were less likely to die.

"Surgical resection is the standard treatment for patients with early stage lung cancer, but after complete resection about 50% will relapse and die from their cancer," says Prof. Vansteenkiste. "Postoperative chemotherapy is able to improve cure rates, but is sometimes poorly tolerated by patients recovering from thoracic surgery. In addition, not all patients are fit to receive chemotherapy. This is why the signal from this phase II randomized study is important: the reduction in risk of postoperative cancer relapse is similar to the one obtained with postoperative chemotherapy, while the side-effects of this new strategy are minimal compared to chemotherapy."

Most patients only experience mild reactions at the injection site and fever within 24 hours of the injection, he explained. "Therefore, it is suitable for long-term maintenance treatment and for most patients, including older patients or patients in weak physical condition after surgery, allowing them to live a normal life whilst on cancer treatment." A large Phase III trial of the therapy, named MAGRIT, is now underway.