New Cancer Advances: Pancreatic Drug Doubles Survival, Head-and-Neck Therapy Shrinks Tumors

Recent clinical trials and research studies are yielding notable advances against cancer, including a drug that nearly doubled survival in advanced pancreatic cancer, an experimental therapy that shrank tumors in a majority of head and neck cancer patients, and new insights into why some cancers stop responding to treatment.

In a trial of 500 people with advanced pancreatic cancer, those who received the experimental drug daraxonrasib lived another 13.2 months, compared with 6.7 months for those treated with chemotherapy. The drug, developed by Revolution Medicines, disarms all three members of the RAS family of proteins, which are linked to some of the deadliest cancers. The results were presented at the American Society of Clinical Oncology annual meeting in Chicago on 31 May and published in the New England Journal of Medicine.

Another experimental approach showed promise in head and neck cancer. In an international study conducted in 11 countries, amivantamab was administered to 102 patients whose disease had become resistant to both chemotherapy and immunotherapy. In 43 of them, tumors significantly decreased or completely disappeared within a few weeks of starting therapy, and similar results were recorded in patients with lung cancer. Amivantamab targets tumors not associated with human papillomavirus (HPV). The drug has been approved for use in the U.S. and EU since 2021, and researchers continue to explore its potential for other cancers.

In mantle cell lymphoma, a study published July 2 in Nature Communications identified a mechanism of resistance to BTK inhibitors, a widely used class of drugs that reduce the activity of the enzyme BTK and are used against some blood cancers including several types of lymphoma. The researchers found that aberrant activity of the protein BRG1 protects cells from BTK-inhibitor treatment by suppressing ferroptosis, an iron-dependent form of cell death. Adding an inhibitor of BRG1 markedly improved a BTK inhibitor's antitumor activity and extended survival in animal tests.

Research on lung cancer prevention has also drawn attention. A paper published in the journal Cell identified a set of blood proteins that appeared to predict lung cancer five years before it became clinically apparent, and proposed that the monoclonal antibody Canakinumab, which targets interleukin-1 beta, might reduce lung cancer risk among individuals with this protein signature. The proposal is based on a retrospective analysis of the CANTOS trial, a 2017 New England Journal of Medicine study of more than 10,000 patients with previous heart attacks. In that trial, fewer cases of lung cancer occurred in the Canakinumab group than in the placebo group, but there was no systematic screening for lung cancer, and the observation has not been convincingly replicated in independent studies. The Cell paper used machine learning on U.K. Biobank samples to identify a 14-protein plasma signature among people who eventually developed lung cancer.

Progress against cancer overall has been substantial. Since 1991, 34% fewer Americans are dying from cancer, and cancer mortality rates have decreased by almost a quarter (23%) in the UK since the early 1970s. More than 50 million people are alive today after a cancer diagnosis in the last five years, according to the World Health Organization. More than 30 immunotherapies treating 25 different forms of cancer are now approved by the U.S. Food and Drug Administration. Patients with advanced melanoma, who were once expected to survive a mere 16 weeks, now have a one in three chance of living a decade or longer.

In Italy, where over 14,000 people are diagnosed with stomach cancer each year, fewer than 20% of cases are detected at an early stage. Since 80% of gastric carcinomas are directly or indirectly linked to infection with Helicobacter pylori, researchers have called for a public health programme targeting healthy populations to detect the bacterium. Screening would make it possible to increase the five-year survival rate for stomach cancer from around 32% to over 60%.

Cancer burden remains high in developing countries. Nearly 130,000 Nigerians receive a cancer diagnosis each year, and nearly 80,000 die of the disease; an average of 33 women per day in Nigeria are diagnosed with cervical cancer, and 22 women per day die from it. Access to innovative treatments, including immunotherapy, remains limited in many developing countries.

Efforts to improve drug discovery include a platform that lets researchers observe living cells continuously, rather than relying on biological 'autopsies.' The approach could help researchers better understand how cells respond to candidate drugs and fast-track detection of subtle biochemical changes. India reported an estimated 1.4 million new cancer cases in 2022, according to International Agency for Research on Cancer data, and the Indian Council of Medical Research projected that the country's cancer burden will continue to rise.