Lung cancer prevention received a huge if unitended boost as analysis of the CANTOS trial has begun. Canakinumab, a blocker of Interleukin 1β, is FDA approved to treat a variety of very rare autoimmune conditions, was tested in this trial to see whether it has any effect against coronary artery disease. A 15% reduction in deaths from cardiovascular disease was observed.
Published in The Lancet in August 2017 is an article that could be blockbuster in Oncology. The authors, from Harvard Medical School and Novartis, found that as an unintended consequence there was a dramatic decrease in the incidence of new lung cancers in the group that received this drug — about 70%, a stunning result. The vast majority of the enrollees in this study were smokers, so the results have great clinical significance. Click here to see an abstract of the article. If you wish, Dr. Stark can email you the entire article in PDF format; just fill out the form to the right on this page.
The basis for this finding is incompletely understood. Perhpas this drug initiates changes in the immune system within the lungs to counteract the effects of carcinogens on lung tissue. People with the highest levels of inflammatory biomarkers such as C-reactive protein at the time of entry into the trial had the greatest likelihood of seeing this benefit. The authors speculate that given the period of observation of the trial — relatively short in the life span of a new cancer — new cancers were not necessarily prevented entirely but were prevented from growing to the point of being discovered or growing to the point of throwing off metastases.
In any event, as Dr. Stark points out, “The interfact between the inflammatory response and the development of cancer is just beginning to be understood. This trial opens a window into this phenomenon and may yield an entirely new strategy in the prevention of cancer. Stay tuned!!”