If successful, this could mean fewer patients needing oxygen – and save cash-strapped hospitals millions
A trial of the first antibody drug to treat lung cancer has shown it is significantly more effective than the chemo drug at preventing death from the disease.
The trial involved patients who had history of lung cancer but were not eligible for chemotherapy because they had not fully responded to it. Instead, they received a medicine called Xolair, which is already approved as a treatment for asthma and allergy.
AstraZeneca, the pharmaceutical company, claims that in this trial a drug whose main use is asthma is being developed into a way to treat lung cancer that is as effective as chemo – and in some cases, more effective.
AstraZeneca says that if the drug, called AZD1419, is successful, there would be fewer patients needing oxygen and more people using telecare, the use of IV oxygen.
There were 4,760 patients in the trial, and all had adenocarcinoma of the lung. In all the patients, following treatment with AZD1419, 71% of those who could not have chemotherapy were still alive at a median follow-up of 12.4 months. In comparison, 61% of patients who had never had chemotherapy had survived at a median follow-up of 11.8 months. Of those who started with a response to AZD1419, 90% had one at the median follow-up.
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Adenocarcinoma of the lung is the fourth most common form of lung cancer. If approved for treating adenocarcinoma of the lung, AstraZeneca says that this could save more than $13m (£10.9m) in NHS drugs costs.
However, Professor Olufemi Oloko, a researcher at the University of California San Francisco, who was not involved in the research, said that the results on AZD1419 showed that the drug was not effective in the complete prevention of the cancer returning. “There is some evidence suggesting that in the smaller portion of patients that benefit from chemotherapy, oral azi-afilinumab [Xolair] may have benefits in many but not all – that is, those who still have cancer – and this is not the case in the trial.”
He said that there were a number of reasons for the lack of success of Xolair.
“The reasons I discussed in The Lancet in 2013, in contrast to the findings of the patient arm of the trial, is that there are likely to be a subset of lung cancer patients that do not respond to AZD1419 but that do respond to chemotherapy, particularly in the smaller subset of patients that have a specific molecular biomarker of recurrence.”
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Such patients already receive chemotherapy and the results of those patients are typically different. With small numbers of patients being treated, studies often take many years to show what impact the particular drug has on the majority.
The AstraZeneca trial was so large that it was fully funded by the National Institute for Health Research and it is unknown how much the company spent on the research.
Anna Minelli, AstraZeneca’s head of medical affairs for non-small cell lung cancer, said: “It is encouraging that a well-researched target, the fibroblast growth factor receptor [FGF-receptor] is found to work as well in this study as chemo does. This trial supports our expectations that AZD1419 might also be useful in lung cancer patients with a mutant GABAA [a protein often found in non-small cell lung cancer that triggers the FGF-receptor] mutation – and the results in this small subset of patients provided encouragement for the development of long-term maintenance therapies for patients like these.
“Of course this is just one study and we will not know until a more rigorous and robust trial is conducted, but it is encouraging to see continued progress and success of AZD1419 in an overall lung cancer population.”