Cancer cells have the ability to evade the immune system by down regulating the response to cancer cells. A new class of treatment, Immunotherapy with checkpoint inhibitors, such as PD1 or PDL1 antibodies can restore the immune system so that it can recognize and fight cancer cells.

MPDL3280A (also known as anti-PDL1) is an investigational monoclonal antibody designed to interfere with a protein called PD-L1. MPDL3280A is designed to target PD-L1 expressed on tumor cells and tumor-infiltrating immune cells. By inhibiting PD-L1, MPDL3280A may enable the activation of T cells, restoring their ability to effectively detect and attack tumor cells.

This antibody treatment is used in the OAK trial. Patient with lung cancer who have failed certain treatment s before, may be eligible. Patient either receive MPDL3280A or standard of care chemotherapy docetaxel (Taxotere) (A Randomized Phase 3 Study of MPDL3280A (an Engineered Anti-PDL1 Antibody) Compared to Docetaxel in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer Who Have Failed Platinum Therapy - "OAK) (For more information on clinicaltrials.gov click here)

For more information contact Irene, clinical research coordinator at 562-590-0345

For the first time ever, the answer is yes.  And it is an emphatic yes, because we are going through a revolutionary period in lung cancer treatment research that is showing extraordinary hope and promise.  Indeed, the way this new immune therapy (also know as immune checkpoint blockade) works is that it releases the power of the patient’s own immune system so that it can vigorously attack the cancer cells.  It has been astounding to see the actual power of the immune system once it is freed up from blockade and inhibition.  The way this is done is through so called human monoclonal antibodies that attack the cancer cell’s ability to appease the immune system.  The fact is that cancer cells often initiate an immune response, and the normal immune cells as they initiate the attack get a signal from the cancer cells that lead to a stop of this immune attack.  The cancer cells use this method to evade the immune attack. 

The new treatments disengage this mechanism that the cancer cells use and then what you have is a new reality.  The result is a relentless, persistent, and expanding army of so-called “T-cells” that attack and destroy the tumor.  This treatment can be so powerful that it can lead to complete elimination of the cancer over a short period of time.  Clinical trials that have already been completed show the potentially remarkable efficacy of this approach, and new studies are now being planned to try this therapy in patients with lung cancer. 

At our practice at Pacific Shores Medical Group, we have been involved in immunotherapy for over a decade; and indeed we conducted the phase I initial studies of immune checkpoint blockade therapy and presented the results back in 2002.  Eventually the initial molecule that we tested (also known as CTLA4) became an approved, new treatment option for patients with malignant melanoma.  These new immune therapies are also known as PD-1 and PDL-1 antibodies. 

What is exciting about the new immune checkpoint blockade therapy is that it can work in other cancers, and in this particular piece I am excited to share that it can help patients with lung cancer.  Lung cancer has not received all the attention that it deserves.  Lung cancer is highly prevalent and very lethal, and patients suffer from it across our country.  We look forward to participating in immune therapy trial options for patients with lung cancer, and we expect to do so very soon.  

Mutations in epidermal growth factor receptor (EGFR) have been targeted in non-small cell lung cancer with tyrosine kinase inhibitors such as erlotinib (Tarceva).  Recently another agent, afatinib, was submitted to the FDA and granted Priority Review.

Afatinib is a potent oral agent that selectively and irreversible blocks receptors in the ErbB Family, including EGFR (also called ErbB-1). The expanded access program (EAP) is available to provide early acces to patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR mutation(s): LUX-Lung EAP US; An open label expanded access program of afatinib (BIBW 2992) for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring EGFR mutation(s)

The EAP is set up as a clinical research trial but has less restrictive inclusion and exclusion criteria . Key inclusions criteria are locally advanced or metastatic Non-Small Cell Lung Cancer and the presence of EGFR mutation (For more information see ClinicalTrials.gov). 

The EAP is available at our Long Beach Elm Office. For more information call Irene at 562-590-0345.