New cancer drug combination therapy is promising

By RACHEL HUANG | February 28, 2019

Finding a cure for cancer is one of the most highly researched topics in science because of its major impact all over the world. According to the National Cancer Institute, in 2018, there was an estimated 1.7 million new cases of cancer diagnosed in the United States and approximately 17 million new cases worldwide. 

Cancer is one of the leading causes of death worldwide, reaching approximately 10 million deaths in the past year. Continuous cancer research breakthroughs, however, have significantly decreased the cancer mortality rate, with an average declining rate of 1.6 percent per year, for many individual cancer types since the 1990s. 

For the past several decades, significant progress has been made in research for breast cancer, prostate cancer, colon and rectal cancer, and several others. Recently, two new studies have suggested that there may be a new potential treatment for kidney cancer.

According to the American Cancer Society, in 2019, approximately 74,000 new cases of kidney cancer are predicted to occur in the United States for 2019, and approximately 15,000 will die from this disease. 

Kidney cancer is the ninth most common cancer in both men and women and typically affects individuals over the age of 45. The most common type of kidney cancer in adults is known as renal cell carcinoma. 

The cause of renal cell cancer remains unknown, although risk factors such as smoking, obesity, high blood pressure, old age and family history of kidney cancer may increase the risk of being diagnosed. 

Kidney cancer begins with mutations of the DNA of kidney cells. The kidney cells begin to grow and accumulate at an abnormally fast rate. The cells aggregate together to form a tumor. Most kidney cancer cases are caught early because of the power of the computerized tomography (CT) scan. Small tumors that are caught and diagnosed early are easier to treat. 

Surgery to remove the tumor from the kidney — partial nephrectomy — may be enough if the tumor is caught early. In more extreme cases however, removal of the whole kidney — a nephrectomy — may be necessary. If the cancer is too advanced to be removed by surgery, other treatment options may be required.

Advanced and recurrent kidney cancers may be controlled with drug treatments. Two recent studies published in the New England Journal of Medicine suggest the benefit of a new immunotherapy treatment approach for the more advanced kidney cancer cases.

Cancer immunotherapy stimulates the patient’s own immune system to fight cancer in order to stop or slow the growth of cancer cells and to prevent cancer metastasis — the spread of cancer to other parts of the body. 

In one of the studies, 886 renal cell cancer patients participated in the study. The patients were randomly selected to receive one of two treatments: the immunotherapy drug, avelumab, combined with another treatment, axitinib; and the second group received the first-line chemotherapy drug, sunitinib. 

Results from the study found that patients who received the immunotherapy-drug combination, avelumab and axitinib, were able to live progression-free for an additional 13.8 months, while the control group, who received sunitinib, lived progression-free for 7.2 months.

In a second study that used a pembrolizumab-axitinib immunotherapy-drug therapy combination and a sunitinib control group, researchers found that patients who received pembrolizumab-axitinib lived progression-free for 15.1 months compared to the 11.1 month in the sunitinib group. 

Brian Rini was the first author of the pembrolizumab-axitinib study. He is currently an oncologist and a professor of medicine at Case Western Reserve University and Cleveland Clinic Lerner College of Medicine.

“We measure efficacy of cancer drugs in many different ways — patients living longer, first and foremost — but other measures as well [including response to treatment and disease progression], and across all these measures, this combination was superior to sunitinib. The reality is that the addition of the immunotherapy drug did prolong survival more than the standard treatment,” Rini said, according to CNN.

Ongoing research continues to make progress in determining the role of immunotherapy in different cancer treatments.

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