He lung cancer It is one of the tumors with the worst prognosis, which is mainly due to the fact that when it is diagnosed, more than a third of the patients have the disease in an initial or locally advanced stage and surgery or radiotherapy as the only treatment do not usually have good results. because there is usually already micro-metastasis in a lymph node, which is why most patients suffer a relapse.
And new lung cancer treatment developed in a pioneering Spanish research worldwide, has achieved that 36.8% of the patients who receive it experience a complete disappearance of the tumor, compared to 6.9% of those receiving standard therapy in which treatment is applied after surgery. Also, a 85% of patients survive two years after having received chemo-immunotherapy before surgerycompared to 63% receiving chemotherapy alone before surgery.
The study NADIM II has been led by Spanish Lung Cancer Group (GECP) and has been published in the scientific journal The New England Journal of Medicine. Their results confirm the great benefit of chemo-immunotherapy with nivolumab before operating the stage III lung tumors. Specifically, this new treatment standard for lung cancer represents a 20% increase in survival of those affected and can reach benefit more than 6,000 patients a year in all Spain.
“Currently only 30% of patients with early lung cancer survive 5 years. With the NADIM scheme, this percentage could reach 70%”
The Catalan Institute of Oncology is the hospital that has contributed the most patients from all over the State to the study, a total of 18 spread over its territorial centers of Hospitalet (11), Gerona (6) and Badalona (1). The Bellvitge Biomedical Research Institute (IDIBELL), the Girona Josep Trueta Biomedical Research Institute, the Germans Trias i Pujol Research Institute and the Puerta de Hierro University Hospital in Madrid have also participated in the study.
Long-term complete tumor remission and improved survival
The idea and design of the NADIM study arose at the Puerta de Hierro Hospital, hand in hand with the Dr. Mariano Provenciopresident of the Spanish Lung Cancer Group and first author of the study, and it is at this center where all the translational research has also been carried out: laboratory tests, genetic and molecular tests and the determination of which patients responded more or less to this new treatment scheme with chemo-immunotherapy before surgery.
“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 5 years. With the NADIM scheme, this percentage could reach 70%. More than 6,000 patients could benefit from improvements in response to treatment and survival each year in the State”, stated Dr. Provencio.
This specialist adds that “we are not talking about just one drug. We are talking about a change in the therapeutic approach and strategy that involves many professionals: pathologists, surgeons, oncologists or radiotherapists. We have found a significant improvement that may put us on the path to curing a significant number of patients after decades without progress.” Add Provencio in statements to the newspaper The world that “Nadim’s data represents a real advance for an important group of patients with a limited prognosis despite being diagnosed at an early stage. The prognosis was 15 months of progression-free survival. In addition, “it is a short-term therapy, only three doses of nivolumab, together with chemotherapy, that gives very little added toxicity,” he adds to the aforementioned medium.
For his part, for the oncologist from the Catalan Institute of Oncology, researcher at the Bellvitge Biomedical Research Institute and member of the GECP Board, Ernest Nadal“this new treatment modality based on chemotherapy plus immunotherapy is capable of completely eliminating tumor cells from both the tumor and the metastasis affecting regional lymph nodes. This, which used to be something anecdotal like chemotherapy, is now achieved in 37% of patients who have a very high chance of being completely cured. The patients in whom the disease is not eradicated, but who receive the combination, also clearly benefit from this strategy because they achieve greater survival”.
The results of NADIM II open a door to increase the percentage of patients who achieve a complete remission of the tumor long-term. This approach would also make it possible to increase the number of patients who can finally be operated on: 93% of the patients in the combined therapy group underwent surgery after treatment, compared to 69% in the control group.
The NADIM study was a pilot study to test this pioneering therapeutic strategy carried out by an independent research group –formed by 620 multidisciplinary specialists from all over the State– in 46 patients to evaluate the benefits –feasibility, safety, efficacy and survival)– to administer chemo-immunotherapy before surgery to patients with lung cancer in early or locally advanced stages and their results were published in 2020 in The Lancet Oncology. In the NADIM II study, 86 patients from twenty different hospital centers throughout the country have been recruited.
Source: Catalan Institute of Oncology and Hospital Puerta de Hierro
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