Taking the drug osimertinib once a day after cancer surgery can reduce patients' chance of death by 51%, according to trials.
A pill taken once a day cuts the risk of dying from lung cancer in half, according to "exciting" and "unprecedented" results from a decade-long global study.
This is the drug osimertinib, which when patients receive it after surgery dramatically reduces the risk of death by 51%, according to results presented at the world's largest cancer conference.
Lung cancer is the leading cause of cancer death in the world, accounting for approximately 1,8 million deaths annually. The results of the late-stage study, led by Yale University, were presented at the annual meeting of the American Society of Clinical Oncology (Asco) in Chicago.
"Thirty years ago, there was nothing we could do for these patients," said Dr. Roy Herbst, associate director of the Yale Cancer Center and lead author of the study. “Now we have this powerful drug. 50% is a big deal in any disease, but certainly in a disease like lung cancer, which has usually been very resistant to treatments," he said.
The Adaura trial involved patients aged between 30 and 86 in 26 countries and looked at whether the pill could help patients with non-small cell lung cancer, the most common form of the disease.
Those taking part in the trial had a mutation of 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. An EGFR mutation is more common in women than men and in people who have never smoked or were light smokers.
Speaking in Chicago, Herbst said the "exciting" results added enormous weight to earlier findings from the same trial that showed the pill also halved the risk of the disease coming back.
Herbst, assistant dean for translational research at Yale School of Medicine, said the pill proved "practice-changing" and should become the "standard of care" for the quarter of lung cancer patients worldwide with the EGFR mutation .
Some patients in the UK, US and other countries are already able to access the drug, he said, but more should benefit.
Not everyone diagnosed with lung cancer is screened for the EGFR mutation, which needs to change, Herbst said, given the study's findings. "This further reinforces the need to identify these patients with available biomarkers at the time of diagnosis and before initiation of treatment."
Post-surgery treatment with osimertinib, also known as 'Tagrisso' and made by AstraZeneca, "significantly reduced" the risk of death in lung cancer patients, trial results said. "Adjuvant osimertinib demonstrated an unprecedented, highly statistically significant and clinically relevant overall survival benefit in patients," the report said.
After five years, 88% of patients who received the daily pill after their tumor was removed were still alive, compared with 78% of patients who received a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared to those who received placebo.
The survival benefit was "consistently observed" in an analysis across all study subgroups, including those with stage one, stage two and stage three lung cancer. Chemotherapy had been given to 60% of study participants, and the survival benefit of osimertinib was seen regardless of whether prior chemotherapy had been received.
"It's hard to convey how important this finding is and how long it took to get here," said Dr Nathan Pennell, an Asco expert who was not involved in the study. "This shows an unequivocal, highly significant improvement in survival."
About two-thirds of the 682 patients in the trial were women. About two-thirds of the patients also had no history of smoking, suggesting 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 "hugely important".
"A five-year overall survival rate of 88% is incredibly positive news," he said. "Access to a drug whose efficacy is proven and whose side effects are tolerable means that patients can be confident and able to enjoy a good quality of life for longer."