GoKawiilImmunotherapy targets cancer by boosting the immune system’s response to malignant cells.Credit: Garo/Phanie/Science Photo Library
Improving survival with immunotherapy
Even after a lung tumour has been surgically removed, many patients relapse. Immunotherapy is being explored as a way to reduce the risk of relapse. Previous trials have shown that immunotherapy given before surgery can drastically shrink tumours, but long-term studies are needed to determine whether this strategy also results in fewer cases of relapse.
Nature Outlook: Lung cancer
A phase III trial led by Patrick Forde at Trinity College Dublin begins to fill that gap. The team recruited 358 people with non-small cell lung cancer — the most common form of the disease — whose tumours were surgically removable. Each person was randomly assigned to receive chemotherapy alone or in combination with the immunotherapy nivolumab. After treatment, all patients underwent surgery. At the end of five years, 65% of participants who received nivolumab plus chemotherapy were still alive, compared with only 55% who received chemotherapy alone.
The researchers also searched trial data for biomarkers that might predict outcomes. They found that almost every person whose tumour was completely wiped out before surgery was still alive at the five-year mark, compared with only 56% of those who still had detectable cancer cells. Forde’s team also examined circulating tumour DNA (ctDNA) in the blood. Three-quarters of participants whose blood tests revealed no ctDNA before surgery survived the study period, compared with about half of those whose tests confirmed the presence of ctDNA. These markers might serve as early predictors for gauging treatment outcomes.
N. Engl. J. Med. 393, 741–752 (2025)
More-effective screening
Many lives can be saved by using low-dose computed tomography (CT) scans to screen for lung cancer. Screening typically focuses on people aged 50 or older who have a history of heavy smoking. However, there is growing evidence to suggest that offering screening on the basis of a wider set of criteria that influence lung cancer risk might identify people in need of treatment more effectively.
A team led by Jens Vogel-Claussen at Charité University Medicine Berlin compared people selected using conventional criteria based on smoking history with those selected with a risk-prediction model that takes account of other factors, such as family history of lung cancer.
... continue reading