The role of immunotherapy confirmed in a growing number of cancers

Gathered in Barcelona (Spain) for Esmo, the annual congress of the European Society of Medical Oncology, a major event in the fight against cancer, the greatest international specialists are putting the spotlight on this therapeutic technique considered “revolutionary”.

Immunotherapy no longer involves acting on the cancer cell itself, but rather stimulating the patient’s immune system to help it fight against tumors.

At Esmo, specialist doctors and researchers are highlighting this treatment, which has already shown promising results for lung and skin cancers (melanoma), and which improves long-term survival in many other tumors.

This is the case, for example, in triple negative breast cancer. Particularly aggressive, it affects around 9,000 women each year, often young.

It is very difficult to treat, particularly because it does not respond to the administration of estrogen or progesterone, the basis of other treatments commonly used in other forms of breast cancer.

However, immunotherapy combined with chemotherapy, a combination given before surgery, has led to an improvement in long-term survival in patients with triple-negative cancer, according to a study presented Sunday.

According to its results, published simultaneously in the New England journal of medicinetheir risk of death was reduced by 34% after a median follow-up of 75 months.

“Fewer recidivisms”

Here we have proof that “The use of immunotherapy can increase the effectiveness of chemotherapy“, explained François-Clément Bidard, oncologist at the Curie Institute in Paris, to AFP.

And when given before surgery, there is a greater chance that tumor cells will be completely eliminated before the operation.

“We now expect fewer recurrences, and therefore more cures, which is the ultimate goal in oncology.“, commented Benjamin Besse, medical oncologist at Gustave-Roussy, south of Paris.

Michèle Borges-Soler, 51, benefited from this treatment. She is now in remission from triple-negative breast cancer, which she was diagnosed with in November 2022.Advanced, fast-growing and aggressive cancer“, he was told at the time.

“Initially, it was not operable“, she tells AFP. But she is one of the first patients to be treated with immunotherapy for this type of tumor.

Combined with chemotherapy, the treatment gives her “encouraging results” and makes an operation possible in June 2023. Since January, she has not taken “any medication”.

“I think it is possible that there will never be a recurrence.“, wants to believe this”eternal optimist“.

Unanswered questions

A similar improvement in overall survival with administration of immunotherapy before surgery was observed in a study of patients with muscle-invasive bladder cancer.

On Saturday, the results of a study on high-risk locally advanced cervical cancer again reached similar conclusions: a combination of immunotherapy and chemotherapy showed an overall three-year survival rate of 82.6% in affected patients compared to 74.8% for those who did not receive immunotherapy.

“Immunotherapy continues to deliver on its promise“, said Dr. Alessandra Curioni-Fontecedro, professor of oncology at the University of Fribourg.

“Breast, anal canal, bladder, lung, uterus… in many cancers, we see that stimulating the immune system before surgery improves survival substantially“, also commented on the sidelines of the Esmo Jean-Yves Blay, president of Unicancer, a group of French anti-cancer centers. A “turning point”, according to him, in cancerology.

But major questions remain unanswered. For example, we need to understand why immunotherapy does not work in some people. And why cancers recur in patients who initially seemed to respond to treatment.

The side effects, more or less serious and which can be induced by immunotherapy, must also be taken into account before administering this treatment.