Lung cancer pills cut the risk of death in half

Taking just one pill a day cuts the risk of dying from lung cancer in half, according to “exciting” and “unprecedented” results from a 10-year global study.

Taking osimertinib after surgery significantly reduced patients’ risk of dying by 51%, according to findings presented at the world’s largest cancer conference.

Lung cancer is the leading cause of death from cancer in the world, causing about 1.8 million deaths annually. The results of the late-stage study, led by Yale University, were presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

“Thirty years ago, there was nothing we could do for these patients,” said Dr. Roy Herbst, associate director of Yale Cancer Center and lead author of the study. “Now we have this powerful drug.

“50% is a big problem in any disease, but certainly in a disease like lung cancer, which is usually very resistant to treatments.”

The Adaura trial included patients ages 30 to 86 in 26 countries and looked at whether birth control pills could help patients with non-small cell lung cancer, the most common form of the disease.

Everyone in the trial had a mutation in the EGFR gene, which is found in about a quarter of lung cancer cases worldwide and accounts for up to 40% of cases in Asia. EGFR mutation is more common in women than in men and in people who have never smoked or were light smokers.

Speaking in Chicago, Herbst said the “exciting” findings added enormous weight to previous findings from the same trial that showed the pill also halved the risk of the disease returning.

The pill has proven a “practice changer” and should become “the standard of care” for the quarter of lung cancer patients worldwide with an EGFR mutation, said Herbst, assistant dean for translational research at Yale University School of Medicine.

He said some patients in the UK, US and other countries are already able to access the drug, but more should benefit.

Not everyone with lung cancer is screened for the EGFR mutation, which would need to be changed, Herbst said, in light of the study findings. “This reinforces the need to identify these patients with biomarkers available at the time of diagnosis and before treatment begins.”

Trial results said postoperative treatment with osimertinib, also known as Tagriso and made by AstraZeneca, “significantly reduced” the risk of death in patients with lung cancer. “The adjuvant osimertinib demonstrated an unprecedented, highly statistically significant and clinically relevant benefit on survival in patients,” the report stated.

Five years later, 88% of the patients who took a daily pill after the tumor was removed were still alive, compared to 78% of the patients who received a placebo. Overall, there was a 51% lower risk of death for those treated with osimertinib compared to those given placebo.

The survival benefit was ‘consistently’ observed in an analysis across all study subgroups, including stage I, stage II, and stage III lung cancer. Chemotherapy was given to 60% of the study participants, and a survival benefit from osimertinib was seen regardless of whether previous chemotherapy had been received.

“It’s hard to say how important this finding was and how long it took to get here,” said Dr. Nathan Bennell, an Asco expert who was not involved in the study. “This indicates a clear and very important improvement in survival.”

About two-thirds of the 682 patients in the trial were women. About two-thirds of the patients had no history of smoking, which indicates that the pill works for smokers and non-smokers diagnosed with lung cancer.

Angela Terry, chair of EGFR Positive UK, a lung cancer charity, said the findings were “very exciting” and “very important”.

“The five-year survival rate of 88% is incredibly positive news,” he said. “Having access to a drug that has proven efficacy and whose side effects are tolerated means that patients can be confident and able to enjoy a good quality of life for longer.”