The Lancet | Chinese Medical Team: A New Breakthrough in the Treatment of Limited-stage Small Cell Lung Cancer!

High-dose Accelerated Hyperfractionated Radiotherapy Helps Improve Treatment Efficacy

Lung Cancer

Small-cell lung cancer (SCLC) is a highly aggressive malignancy, accounting for 15% of all lung cancer cases. Among these, one-third are diagnosed with limited-stage SCLC (LS-SCLC), where the disease is confined to one side of the chest. For the past two decades, the standard treatment for LS-SCLC has been concurrent chemoradiotherapy, yet patients have seen little improvement in survival outcomes, with median survival ranging from 25-30 months.

A recent study led by a team of Chinese researchers has shed light on a new treatment strategy. Published in The Lancet Respiratory Medicine, this multicenter, open-label, randomized phase III trial demonstrated that a high-dose, accelerated, hyperfractionated thoracic radiotherapy (54 Gy/30 fractions) combined with chemotherapy significantly improves overall survival (OS) and progression-free survival (PFS) for LS-SCLC patients. Importantly, this breakthrough treatment does not increase toxicity compared to the standard 45 Gy/30 fractions regimen.

The trial, conducted between 2017 and 2021, enrolled 224 patients across 16 hospitals in China. The patients, aged 18-70, had histologically or cytologically confirmed LS-SCLC and had either not yet received treatment or had undergone 1-2 cycles of chemotherapy. After chemotherapy, they were randomly assigned to receive either the high-dose (54 Gy/30 fractions) or standard-dose (45 Gy/30 fractions) thoracic radiotherapy, delivered twice daily over three weeks. Both groups also underwent four cycles of chemotherapy and, if responsive, prophylactic cranial irradiation (PCI) to prevent metastasis.

The study’s results were groundbreaking. Patients in the high-dose group showed a remarkable improvement in OS, with a median survival of 60.7 months, compared to 39.5 months in the standard-dose group. Additionally, the high-dose group saw a 45% reduction in the risk of death. Two-year survival rates also favored the high-dose group, with 76% of patients alive at two years, compared to 54% in the standard-dose group.

Progression-free survival was similarly improved, with the high-dose group experiencing a median PFS of 30.5 months, significantly longer than the 16.7 months observed in the standard-dose group. This translates to a 30% reduction in the risk of disease progression or death.

Despite the higher radiotherapy dose, the incidence of adverse effects between the two groups was comparable. The most common severe side effects were neutropenia, thrombocytopenia, and anemia, which occurred at similar rates in both groups. The occurrence of acute radiation-induced toxicity, such as esophagitis and radiation pneumonitis, also showed no significant differences. Importantly, there were no cases of severe late-stage toxicity, such as grade 3 esophageal stenosis or pulmonary fibrosis.

This study demonstrates that high-dose, accelerated hyperfractionated thoracic radiotherapy can significantly improve the prognosis of LS-SCLC patients without increasing treatment toxicity. It provides a new first-line treatment option that offers hope for longer survival. These findings may shift the clinical landscape, offering a viable alternative to the current standard of care.

A groundbreaking study led by a Chinese medical team has demonstrated that high-dose accelerated hyperfractionated chest radiotherapy (54 Gy/30 fractions) combined with chemotherapy significantly improves the overall survival (OS) of patients with limited-stage small-cell lung cancer (LS-SCLC). The research was published in The Lancet Respiratory Medicine on August 12, 2024. Compared to the standard dose of 45 Gy/30 fractions, the 54 Gy regimen increased OS without raising treatment toxicity, marking a potential shift in LS-SCLC treatment strategy.

LS-SCLC, a highly aggressive form of lung cancer, affects around 15% of all lung cancer patients, with one-third of them diagnosed at a limited stage. Traditionally, concurrent chemoradiotherapy (CRT) has been the preferred treatment option for LS-SCLC, yet the median survival rate has remained stagnant at around 25-30 months over the past two decades. The new study, however, highlights the efficacy of using higher doses of radiation to improve outcomes.

This phase III clinical trial was conducted across 16 hospitals in China between June 2017 and April 2021, involving 224 LS-SCLC patients. The trial compared two groups: a high-dose radiotherapy group (54 Gy/30 fractions twice daily) and a standard-dose group (45 Gy/30 fractions twice daily). Patients were treated with four cycles of chemotherapy and monitored through regular follow-ups. The results were remarkable.

Overall Survival: The high-dose group had a significantly extended median OS of 60.7 months compared to 39.5 months in the standard-dose group, reducing the risk of death by 45%.

Progression-Free Survival (PFS): The median PFS was also improved in the high-dose group, standing at 30.5 months compared to 16.7 months in the standard-dose group, with a 30% reduction in the risk of disease progression or death.

Safety: Despite the higher radiation dose, there was no increase in severe treatment-related side effects, such as neutropenia, thrombocytopenia, or radiation-induced pneumonia. Both groups exhibited similar rates of acute and long-term radiation toxicity.

The study’s findings suggest that 54 Gy/30 fractions, delivered twice daily, may become a new standard of care for LS-SCLC patients. This approach significantly extends survival while maintaining a similar safety profile to the current standard dose. Moreover, with a two-year OS rate of 76% in the high-dose group, compared to 54% in the standard-dose group, the potential for long-term remission appears much greater.

While the current trial focused on radiotherapy and chemotherapy alone, future studies could explore combining this high-dose radiotherapy with immunotherapy. Recent breakthroughs, such as the ADRIATIC trial, have shown that immunotherapy following CRT can further improve survival outcomes for LS-SCLC patients. However, the safety of combining high-dose radiotherapy with immunotherapy needs further investigation due to potential risks like radiation-induced pneumonitis.

In conclusion, this study has paved the way for a new treatment option in LS-SCLC, offering hope for improved survival rates without additional toxicity. It marks a significant milestone in the battle against this aggressive form of lung cancer, providing a valuable alternative to the long-standing standard treatments.

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7 months ago Myeloma

🩸 Breakthrough in Multiple Myeloma Treatment! 🩺

🩸 Breakthrough in Multiple Myeloma Treatment! 🩺

LANCET

🔬Targeting GPRC5D with CAR-T Cells shows immense potential in treating relapsed or refractory multiple myeloma patients.
Multiple myeloma, a malignant disease characterized by clonal plasma cell proliferation in the bone marrow, has remained incurable despite substantial progress in treatment methods such as systemic chemotherapy, radiation therapy, and hematopoietic stem cell transplantation (HSCT). However, CAR-T cell therapy targeting B-cell maturation antigen (BCMA) has demonstrated activity in treating relapsed or refractory multiple myeloma. Nonetheless, the escape of BCMA-low or BCMA-negative myeloma cells has led to treatment resistance and relapse, highlighting the need to explore new targets.

 

💪In February 2023, a groundbreaking study titled “GPRC5D CAR T cells (OriCAR-017) in patients with relapsed or refractory multiple myeloma (POLARIS): a first-in-human, single-center, single-arm, phase 1 trial” was published in The Lancet Haematology. The study aimed to evaluate the activity and safety of G-protein-coupled receptor class 5 member D (GPRC5D) CAR-T cells (OriCAR-017) in patients with relapsed or refractory multiple myeloma.

 

🌈Promising Treatment Response with OriCAR-017 Infusion
All ten patients (100%) demonstrated an overall response, with 6 patients (60%) achieving a complete response and 4 patients (40%) showing very good partial responses. The patients with complete responses met stringent complete response criteria, and all patients achieved minimal residual disease (MRD) negativity by day 28. Serum M-protein concentrations gradually decreased, and patients’ clinical responses improved over time. The median time to the best response was 3.1 months, while the median time to a complete response or better was 4.1 months.

☀️Among the 5 patients who relapsed after BCMA CAR-T cell therapy, 2 patients achieved a stringent complete response, and 3 patients showed very good partial responses. Four patients had extramedullary disease at enrollment, with the largest tumor volume measuring 70 cm³. PET-CT scans revealed complete resolution of extramedullary lesions in three patients, while the extramedullary disease in one patient continued to shrink. Furthermore, no severe adverse events or treatment-related deaths were reported.

🌱Favorable Survival Outcomes after OriCAR-017 Infusion
⏰The median follow-up time for all patients was 238 days, with two patients progressing after achieving stringent complete remission. One patient experienced GPRC5D-positive relapse, with GPRC5D expression in malignant plasma cells increasing from 34.5% at baseline to 35.8% at relapse. The other patient experienced GPRC5D-negative relapse, with GPRC5D expression in malignant plasma cells decreasing from 86.8% at baseline to 6.9% at relapse. The remaining eight patients in ongoing remission were all negative for minimal residual disease, and no deaths occurred. The median progression-free survival time was not reached, but the estimated progression-free survival rate for all patients at nine months was 87.5%.

🧬Durable CAR-T Cell Persistence
✨CAR-T cell expansion was detected in all patients after infusion, with a median time to maximum CAR-T cell expansion (Cmax) of 10.0 days and a median Cmax of 7930 copies/μl. CAR-T cells exhibited favorable persistence in the body, with CAR-T cells still detectable in 90% of patients at one month, seven patients at three months, and four patients at six months.

🌟 The study results demonstrate that targeting GPRC5D with CAR-T cells in treating relapsed or refractory multiple myeloma patients is safe and shows promising activity. The observed targeted and off-target toxicities associated with GPRC5D were manageable, indicating the potential of GPRC5D as an effective immunotherapeutic target for multiple myeloma. These findings provide a foundation for subsequent phase 2 studies to further validate the efficacy and safety of targeting GPRC5D CAR-T cells in multiple myeloma.🦾

We can help all international patients come to China to receive anticancer therapies such as CAR-T, TILs, and cancer vaccines.
We have access to medical resources from all cancer hospitals in China and can assist patients in receiving treatment from the best and top-tier oncologists in the CHINA.
doctor.huang@globecancer.com
WhatsApp+8613717959070

🔬 Stay tuned for more updates on this groundbreaking research! Together, we can conquer multiple myeloma!

#MultipleMyelomaResearch #CARTTherapy #GPRC5D #MedicalBreakthrough #cart #multiplemyeloma #chinesecart #cartcell #carttherapy #LANCET #Haematology #CARTCell

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9 months ago CAR-T

Chinese Hengrui Pharmaceuticals ‘s indication for cervical cancer has been approved for clinical trials.

🌟 Chinese Hengrui Pharmaceuticals ‘s indication for cervical cancer has been approved for clinical trials.🌟

cervical cancer

🏥💊（Jiangsu Hengrui Pharmaceuticals Co., Ltd）Hengrui Pharmaceutical’s PD-L1 inhibitor Atezolizumab injection combined with concurrent chemoradiotherapy for the treatment of locally advanced cervical cancer has been approved for open, multicenter Phase II clinical trials.

Atezolizumab

🌸🎀#Cervical cancer is the fourth most common cancer in women globally, mainly caused by persistent infection with high-risk human papillomavirus (#HPV). Although the widespread implementation of #cervicalcancer screening and the availability of HPV vaccines have reduced the incidence of cervical cancer in developed countries, it remains one of the common malignant tumors in women.

 

🏥💊Atezolizumab injection is a humanized anti-PD-L1 monoclonal antibody independently developed by Hengrui Medicine. It is the first PD-L1 inhibitor approved for the treatment of small cell lung cancer in China. By specifically binding to the PD-L1 molecule, it blocks the PD-1/PD-L1 pathway that leads to tumor immune tolerance, reactivating the immune system’s anti-tumor activity and achieving the goal of tumor treatment.

The Lancet Oncology

🌸🎀Atezolizumab injection has been studied in various fields, including small cell lung cancer, #NSCLC non-small cell lung cancer, esophageal cancer, liver cancer, and cervical cancer. It has shown promising efficacy in small cell lung cancer. Based on the results of the SHR-1316-III-301 study, the application for the market approval of Atezolizumab injection combined with chemotherapy as first-line treatment for extensive-stage small cell lung cancer has been accepted and approved in China in March 2023. The study results have been published in the top international medical journal “The Lancet Oncology,” and the original research from China has been internationally recognized.

🏢💊Jiangsu Hengrui Pharmaceuticals Co., Ltd is committed to advancing the clinical research of the PD-L1 inhibitor Atezolizumab injection, bringing more innovative and effective treatment options for cervical cancer patients. Stay tuned for our progress!

Hengrui Pharmaceutical

🚑In addition to Cervical cancer, we are currently urgently recruiting patients with B-cell lymphoma, T-cell lymphoma, T-cell leukemia (T-ALL), acute lymphoblastic leukemia, myeloma, and other types of cancer!

You can send electronic copies or photos of genetic testing reports and diagnostic reports to the 📩email address: doctor.huang@globecancer.com📩, or click on the ✉️WhatsApp+8613717959070✉️ icon on the homepage. The Medical Department will contact you as soon as they receive the reports.

#CervicalCancerTreatment #Atezolizumab #HengruiMedicine #ClinicalTrials #CancerTreatment #cervical #cervicalcancer #chinesemedicine #newdrug #Lancet #TheLancetOncology

 

📩References：　　

[1]gco.iarc.fr(WHO statistics)

　　[2]Rose PG,Bundy BN,Watkins EB,Thigpen JT,Deppe G,Maiman MA,Clarke-Pearson DL,Insalaco S:Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer.N Engl J Med1999,340(15):1144-1153.

　　[3]Pfaendler KS,Tewari KS:Changing paradigms in the systemic treatment of advanced cervical cancer.Am J Obstet Gynecol2016,214(1):22-30.

　　[4]Liu C,Lu J,Tian H,Du W,Zhao L,Feng J,Yuan D,Li Z:Increased expression of PDL1by the human papillomavirus16E7oncoprotein inhibits anticancer immunity.Mol Med Rep2017,15(3):1063-1070.

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9 months ago CAR-T

2024 Lancet: Revolutionizing Cancer Treatment: China’s Breakthroughs in CAR T-Cell Therapy

🌟2024 Lancet:  Revolutionizing Cancer Treatment: China’s Breakthroughs in CAR T-Cell Therapy 🌏

LANCET

 

Dive into the cutting-edge world of CAR T-cell therapy, where China is making waves in the realm of cellular treatments. Since the inception of CAR T-cell clinical trials in 2013, this groundbreaking therapy has become a beacon of hope for cancer patients across the country.

🔬 Explosive Growth: By 2017, China led the globe in the number of CAR T-cell-related clinical trials, marking a pivotal moment in the evolution of cancer treatments. Fast forward to 2021, and Chinese cell therapy companies have amassed a staggering $237 million in funding, reflecting the robust expansion of CAR T-cell therapy in the nation.

🌐 Government Support: A deep dive into the research unveils the influential role of Chinese government policies in propelling CAR T-cell therapy forward. Strong governmental backing, coupled with capital influx, massive patient demand, and a unique healthcare system, lays the foundation for the accelerated growth of this revolutionary therapy in China.

🎗️ Overcoming Challenges: While CAR T-cell therapy is still in its infancy for solid tumors, it has achieved remarkable success in treating blood cancers. China has emerged as a global leader in conducting clinical trials, particularly focusing on hematologic malignancies like B-cell lymphomas. CAR-T cells, reprogrammed to combat cancer, offer a beacon of hope for those facing these formidable diseases.

🚀 Pushing Boundaries: Beyond blood cancers, Chinese researchers are actively exploring the potential of CAR-T cell therapy in various solid tumors. Preliminary studies hint at promising results for liver, pancreatic, and brain cancers. China’s commitment to medical innovation shines through as it pushes the boundaries of cancer research and treatment strategies.

🌈 Hope for the Future: Join us in celebrating the strides China is making in cancer research. Every breakthrough in CAR T-cell therapy brings us closer to a future where cancer is not just treated but conquered.

💪🏼🔬 #CARTCellChina #MedicalInnovation #CancerBreakthrough #HopeForTheFuture #GlobalHealthRevolution #CellTherapy #LANCET #HEMATOLOGY