New lung cancer treatment boosts survival and could benefit more than 6,000 patients a year

A new lung cancer treatment has allowed 36.8% of patients to achieve complete tumour disappearance, compared to the 6.9% rate of the standard post-surgery treatment. In addition, 85% of patients survive two years after receiving chemo-immunotherapy before surgery compared to 63% who receive chemotherapy alone before surgery. The study involved oncologist from ICO Badalona and IGTP researcher, Teresa Morán.

The NADIM II study has managed to consolidate a new standard of treatment for early lung cancer that represents a 20% increase in survival and could benefit more than 6,000 patients a year throughout Spain. The results of this study, led by the Spanish Lung Cancer Group, have been published in the scientific magazine 'New England Journal of Medicine' and confirm the great benefit of chemo-immunotherapy with nivolumab before surgery for stage III lung tumours.

The study involved the participation of the Catalan Institute of Oncology (ICO), the Bellvitge Biomedical Research Institute (IDIBELL), the Girona Biomedical Research Institute (IDIBGI), and the Germans Trias i Pujol Research Institute (IGTP).

According to the president of the Spanish Lung Cancer Group and first author of the study, Mariano Provencio, "This study has opened the door to a global change in the treatment of patients with early lung cancer, since currently only 30% of these patients survive to 5 years. With the NADIM scheme, this percentage could rise to 70%. More than 6,000 patients could benefit from improvements in treatment response and survival each year in Spain".

Ernest Nadal, oncologist at the Catalan Institute of Oncology, researcher at the Bellvitge Biomedical Research Institute and member of the GECP Board, said, "this new treatment modality based on chemotherapy plus immunotherapy is capable of completely eliminating the tumour cells from both the tumour and the metastases that affect the regional lymph nodes. This, which was previously anecdotal with chemotherapy, is now achieved in 37% of patients who have a very high chance of being completely cured. Patients who fail to eradicate the disease but who receive the combination also clearly benefit from this strategy because they achieve a longer survival".

Participating in this work are also Teresa Morán, an oncologist at ICO Badalona and researcher of the Badalona Applied Research Group in Oncology (B·ARGO) at IGTP, as well as Joaquim Bosch, a medical oncologist at ICO Girona and researcher at IDIBGI.

More responses to treatment and more patients operated on

The NADIM II results open the door to increasing the percentage of patients achieving complete tumour remission in the long term. In this sense, the data show that 36.8% of patients achieve complete tumour shrinkage, compared to 6.9% who do so with the traditional approach of applying the treatment after surgery.

The improvement in survival is also very clear, 20% higher, since with chemo-immunotherapy before surgery 85% of patients survive two years after treatment compared to 63% with the traditional approach of applying the treatment afterwards.

This approach would also increase the number of patients who eventually undergo surgery: 93% of patients in the combination therapy group underwent surgery after treatment, compared to 69% in the control group.

About NADIM studies

This independent research group, made up of 620 multidisciplinary specialists from all over Spain, was a pioneer in 2019 in initiating a study of the potential benefits of this therapeutic strategy with its NADIM study. NADIM, a pilot study in 46 patients, was the first research worldwide to analyse the benefits (feasibility, safety, efficacy and survival) of administering chemo-immunotherapy before surgery to patients with early-stage or locally advanced lung cancer.

The results were published in 2020 in the journal "The Lancet Oncology". From this pilot study, the GECP launched NADIM II, where there were two treatment arms comparing standard versus combined chemo-immunotherapy. The findings presented validate the initial results and represent a paradigm shift. The NADIM II study recruited 86 patients from 20 different hospitals across the country.

Reference

Mariano Provencio, M.D., Ph.D., Ernest Nadal, M.D., Ph.D., José L. González-Larriba, M.D., Ph.D., Alex Martínez-Martí, M.D., Reyes Bernabé, M.D., Joaquim Bosch-Barrera, M.D., Joaquín Casal-Rubio, M.D., Virginia Calvo, M.D., Ph.D., Amelia Insa, M.D., Santiago Ponce, M.D., Ph.D., Noemí Reguart, M.D., Ph.D., Javier de Castro, M.D., Ph.D., et al. Perioperative Nivolumab and Chemotherapy in Stage III Non-Small-Cell Lung Cancer. New England Journal of Medicine. June 28, 2023 DOI: 10.1056/NEJMoa2215530

News shared with the Catalan Institute of Oncology (ICO).