The Concoction Proves Better

Ipilimumab used in combination with paclitaxel/carboplatin for stage IIIb/IV non-small cell lung cancer showed superior results in progression free survival when compared to paclitaxel/carboplatin alone.

Paclitaxel/carboplatin are commonly used chemotherapy drugs in lung cancer patients. Ipilimumab is a human monoclonal antibody that is used to activate the immune system. It works by blinding to and blocking the activity of CTLA-4, a molecule on T-cells that is thought to play a large role in regulating natural immune responses, which as a result sustains an active immune response when attacking cancer cells.

Researchers in this randomized phase II trial sought to determine if adding ipilimumab to treatments for stage IIIb/IV lung cancer patients would impact overall survival and progression free survival. Over 200 patients were treated using ipilimumab plus a concurrent schedule of paclitaxel/carboplatin, ipilimumab plus a phased schedule of paclitaxel/carboplatin or paclitaxel/carboplatin alone.

With both schedules, using ipilimumab in combination with paclitaxel/carboplatin showed improved progression free survival rates when compared to paclitaxel/carboplatin alone. The phased schedule did show better efficacy than the concurrent schedule, but in no instance did ipilimumab increase paclitaxel/carboplatin related toxicity.

"Phase III and IV lung cancers do not often see positive end results, so there is a lot of room to improve treatments for this disease," Thomas Lynch, M.D., lead author of the study, a professor of medicine at Yale University in New Haven, Conn., and director of the Yale Cancer Center, said. "Ipilimumab is one of the few immunotherapies that have shown positive results in treating lung cancers, and if adding this to standard treatments can improve survival, then it is worth further trials."

This finding was presented at the 2010 Chicago Multidisciplinary Symposium in Thoracic Oncology. This symposium is sponsored by the American Society for Radiation Oncology (ASTRO), the American Society of Clinical Oncology (ASCO), the International Association for the Study of Lung Cancer (ISLAC) and the University of Chicago.