2023-06-06 16:07:37
A DNA abnormality specific to cancer cells. Personalized medicine. And a molecule adapted for each cancer. This has been the goal of medical research for years. With it, new appropriate treatments are emerging, bringing new hope in the face of the disease.
This is the case with tepotinib, a new molecule, and the clinical trial carried out by the Toulouse professor Julien Mazières, pneumo-oncologist at the Toulouse University Hospital, which replaces chemotherapy with a simple stamp for a certain type of cancer. “For years, we have better understood the biology of lung cancer and its variants, its dozen “subgroups”. We can now carry out more in-depth analyzes of these cells and highlight molecular anomalies,” explains the specialist. In fact, lung cancer can vary from one group of people to another depending on a particular genetic mutation. In this, local as well as global medical research is focused on determining these mutations and finding a treatment that can respond to them.
The Vision study, presented on May 4 at the World Oncology Congress in Chicago and published the same day in the journal JAMA Oncology, looked at the use of tepotinib to treat a genetic mutation that affects 4 to 5% of patients with so-called “non-small cell” lung cancer, itself representing 80 to 90% of cases. This genetic mutation initiates and aggravates cancer by promoting the uncontrolled proliferation of cancer cells. She has a very bleak prognosis.
“We can’t talk regarding healing”
“Thanks to treatment with tepotinib, we have been able to observe real benefits for patients with this mutation: reduction in the size of the tumor, reduction in metastases, a life without the side effects of chemo and without the rapid development of the disease”, emphasizes Julien Mazières. Thanks to a simple stamp, these patients at an advanced stage experience a phase of respite, more time than what chemo can offer them. “Survival is prolonged without it being possible to speak of a cure”, specifies the rapporteur of the study. “Neither these molecules nor chemo completely eradicate the disease. But tepotinib offers better living comfort and lengthens recurrence-free survival,” he adds.
A successful clinical trial and following?
Regarding the Vision study, conducted from September 2016 to May 2021 and including 313 patients worldwide, the results are far superior to what is usually observed in the context of chemotherapy treatments, with an objective response rate of 51.4%. But for now, this treatment is not authorized by the French Medicines Agency. “They might ask for a new larger clinical trial or new studies before positioning themselves. In France, at the present time, there is not enough sufficient evidence for tepotinib to arrive on the market in the coming months and be reimbursed. This treatment only concerns, for the moment, clinical trials”, reveals the Toulouse researcher.
But another treatment is arriving on the French market and is being reimbursed. This is osimertinib (marketed under the name Tagrisso) developed by the pharmaceutical group AstraZeneca and also presented at the Chicago congress on May 4. It concerns patients with so-called “non-small cell” cancer, as in the Toulouse trial, and also presenting with a particular type of mutation, but different from that in the Vision clinical trial.
Another treatment put on the market
This mutation affects 10% to 25% of lung cancer patients in the United States and Europe. The clinical trial included 680 participants at an early stage of the disease, in more than twenty countries. Taking the tablet following surgery resulted in a 51% reduction in the risk of death for treated patients, compared to placebo. “It’s different for this test. The genetic anomaly is more common first of all and we are talking regarding earlier and operated cancers, ”decrypts Julien Mazières. Whatever the case, the precise analysis of the molecular profile of each patient’s cancer is necessary to propose the most appropriate treatment. Toulouse is positioning itself in this direction in its scientific research.
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