La fotografia delle mutazioni del tumore renderà l'immunoterapia ancora più precisa / The photograph of tumor mutations will make immunotherapy even more precise
Segnalato dal Dott. Giuseppe Cotellessa / Reported by Dr. Giuseppe Cotellessa
The analysis of a new biomarker, which provides precise information on molecular alterations, helps to choose the best treatment from the moment of diagnosis
The analysis of a new biomarker, which provides precise information on molecular alterations, helps to choose the best treatment from the moment of diagnosis.
Give each patient the right therapy, in the right place at the right time. This is the goal of precision immunotherapy, one of the most promising weapons in the field of oncology, in particular for the fight of lung cancer. That today becomes even more effective: the Phase III Checkmate-227 study, whose initial results have just been presented at the Congress of the American Association for Cancer Research (Aacr) in Chicago, has in fact identified a new biomarker, the so-called Tumor Mutational Burden (Tmb, ie the mutational load of the lung), which represents a very high resolution photograph of the molecular alterations of lung cancer cells, and which will help to develop immunological therapies - that is to stimulate the action of the system immune system against cancer - even more precise and effective, even compared to more conventional approaches such as chemotherapy.
There are over 40 thousand new lung cancer diagnoses registered in Italy in 2017. It is a neoplasm that represents 11% of all new cancer cases in the general population and for which, unfortunately, at the moment the survival of 5 years is still very low and around 16% of patients. But the horizons of the research allow us to look with moderate optimism to the future: "The positive data of this study", says Federico Cappuzzo, director of the Department of Oncoematology of the AUSL Romagna, during a meeting with journalists in Rome, " the great potential of Tmb as an important predictive biomarker for the selection of patients eligible for combination treatment with two immunotherapeutic molecules, nivolumab and ipilimumab, in advanced non-small cell lung cancer. The results of the work showed that the rate of progression-free survival at one year was more than three times in patients treated with immunotherapy and chemotherapy compared to those treated with chemotherapy alone ".
The scenario opened by the identification of this biomarker, in essence, represents a significant paradigm shift in oncological immunotherapy: "Il Tmb", continues Michele Maio, director of the Immuno-oncology Center and of the Complex Operative Unit of Oncological Immunotherapy of 'Unitary Hospital of Siena, "is a valuable tool, because it can help identify patients who are better able to respond to immunotherapy and help doctors select the right treatment for each individual patient at each stage of therapy." In addition to being more effective and safe, precision therapies will therefore hopefully become even more sustainable, since the accurate knowledge of the molecular profile of the tumor will allow it to be administered to patients for whom a good success rate is already estimated a priori. And the approach can also be replicated for other types of cancer: "In the literature", concludes Maio, "data on Tmb are already available in other pathologies: it has been shown that the tumors with Tmb higher are, in addition to the tumor of the lung, melanoma and bladder and gastrointestinal tumors ".