Dr. Mazzocchi discusses the limits and benefits of immunotherapies, as well as the importance of genetic testing in determining cancer diagnosis and treatment in patients.
Mutations in cancer have always presented a challenge for doctors and patients alike. Lung cancer has several known mutations that have been extensively studied, with an ever-evolving list of inhibitors and therapies that followed suit.
In the newest episode of Lungcast, Andrea Mazzocchi, PhD, co-founder and chief executive officer of Known Medicine, and adjunct professor at Wake Forest University, sat down with host and American Lung Association (ALA) chief medical officer Al Rizzo, MD, to talk about the known mutations regarding lung cancer, the methods for treating these mutations, and immunotherapy and checkpoint inhibitors that can be used to determine cancer in patients.
Of the mutations mentioned, Dr. Mazzocchi noted that the EGFR mutation remained the most known. Approximately 10% of non-small cell lung cancer patients develop an EGFR mutation, which also affects approximately 50% of non-smokers as well, something that Mazzocchi said intrigued researchers.
Several treatments are available for EGFR positive patients, such as the therapy drug erlotnib.
During the discussion, Mazzocchi spoke of the importance of genetic testing, which could lead to more appropriate cancer treatment for patients.
“There’s a lot of opportunities to start using this genetic testing to start matching the patients with (the stages of cancer progression) as well as the mutations, and to what treatment would work best for them,” Mazzocchi said.
While there are a variety of treatments for EGFR mutations, KRAZ mutation treatments remain more elusive. There are considerably less treatments for KRAZ mutations, but that is subject to change in the intervening years.
“Unfortunately, lung cancer affects so many patients, especially in comparison to other cancers, that there’s a lot of development around EGFR and KRAS mutations,” Mazzocchi said “A lot of these can be dictated or driven by these genetic tests and are a great option for patients who have been identified with mutations.”
Additional mutations were discussed in the episode, with potential off-label treatments referenced as well. Mazzocchi suggested that many of the therapies referenced would be treated in parallel with chemotherapies and immunotherapies.
Later in the discussion, Dr. Rizzo and Dr. Mazzocchi discussed the future of immunotherapy in cancer treatment.
Mazzocchi spoke of the “huge promise” that the current 5 immunotherapies presented. She noted that cancer cells tend to disrupt the immune cells with additional receptors that make it harder for immune cells to identify the threat. Luckily, the inhibitors used in immunotherapies can help properly identifying and attacking the cancer cells.
“That’s why these (immunotherapies) are so exciting,” Mazzochi said. “You’re really turning on your immune system.”
While the differences in safety between the PDR1 and CTL4 immunotherapies were noted, she added that there had been an “amazing response” by patients that include reductions in tumor size and quick recovery rates.
“I think there’s a huge amount of promise and a lot of development still to be had, but these treatments are hugely helpful for the population receiving them,” Mazzocchi said.
To learn more about genetic testing, immunotherapies, and microbiomes of cancer referenced in the interview, watch the video above.
To hear all of Dr. Rizzo’s engaging conversation with Dr. Mazzochi, listen to Lungcast below.