The first immunotherapy for one of the most aggressive types of lung cancer approved in Spain






The small cell lung cancer (SCLC) o de small cells, fast growing, aggressive and unfavorable prognosis, it is one of the tumors against which little progress has been made in the last 30 years. But from now on, Spanish patients can have access to the first immunotherapy drug that they can, according to the president of the Spanish Lung Cancer Group (GECP), Mariano Provencio, create a «new standard of treatment»For a tumor with a poor prognosis that has barely made any progress.

The Ministry of Health has just authorized and financed the treatment with the monoclonal antibody atezolizumab as first-line therapy in combination with chemotherapy for patients with metastases.

Clinical trials have shown both an increase in overall survival and progression-free survival. “There is a 30% lower risk of mortality per year,” he highlighted.

Until now, with chemotherapy treatment, only 6% of patients exceed the mean survival (9.5 months) at two years, a percentage that with the new combined treatment increases up to 22%.

“A percentage that,” acknowledges Provencio, “although still insufficient, is very high compared to the 6% that we achieved with the treatments available so far. Something that is a true milestone in immunotherapy: in the long term we achieve this increase in living people. An advance from which they will be able to benefit about a 60% of patients diagnosed».

Although, “we have many treatments, we have been for more than 20 years without there being anything that really changed the prognosis of these people,” says this oncologist who treated the first patient with this therapy last week. “The first time we changed the treatment for this type of cancer.”

The patient profile is that of a male (over 60 years old, a smoker and with other previous pathologies and, therefore, with an unfavorable prognosis.

The drug is an anti-PD-L1 monoclonal antibody that confirms the benefit of activating the immune system against tumor cells. It was the first of the PD-L1 inhibitor family to arrive and Spain has participated in the clinical development of this therapy, in the studies IMpower133, published in The Lancet and IMfirst, with 36 hospitals and 180 patients from different communities.

The indication approved in Spain is in combination with chemotherapy, as initial treatment for adults with this type of extended-stage tumor. The patient profile, Provencio details, is that of a male (over 60 years old, a smoker and with other previous pathologies and, therefore, with an unfavorable prognosis.

Regarding the cost, the company Roche It has been referred to the document of the Ministry that indicates that the drug “has been financed under a new mixed model of payment for results and discount application, which has allowed its inclusion in the pharmaceutical provision of the SNS through a model that makes the titular laboratory jointly responsible. in the management of the clinical and financial uncertainty associated with the use of this medicine ”.

The effectiveness of this medicine will be registered in the Information System to determine the Therapeutic Value in the Real Clinical Practice of Medicines of High Health and Economic Impact in the SNS (VALTERMED).

According to data from a study conducted since the GECP, of the 22,000 people in the registry, about 12% are small cell tumors. Of these, 78% are men and the majority are smokers, with a mean age of 64 years.

The most important symptom at diagnosis is cough and 20% have brain metastases. Median survival, according to this study, is nine and a half months and, at two years, does not exceed 6% of patients alive.

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