There is hope that a new lung cancer trial combining Keytruda and Tumor Treating Fields could lead to a new treatment for pleural mesothelioma.
Recent studies show Keytruda (pembrolizumab) is one of the most promising immunotherapy drugs against malignant mesothelioma. Electrical device Tumor Treating Fields is only the second treatment to receive FDA approval for mesothelioma.
This summer, the manufacturers of these two treatments announced they would team up. They will test Keytruda and Tumor Treating Fields in patients with non-small cell lung cancer. The results could impact the future of mesothelioma treatment, too.
Two Promising Therapies: Keytruda
Keytruda is an immunotherapy drug. It blocks a protein called PD-1. Many types of cancer cells overproduce PD-1 to evade the immune system. Research suggests almost 3 out of 4 mesothelioma tumors overexpress PD-1.
Chemotherapy is the main treatment for mesothelioma. But it does not work for everyone. Scientists are always looking for ways to make it better.
Keytruda gained national attention as a potential mesothelioma treatment in 2015. Three quarters of mesothelioma patients responded to a combination of Keytruda and chemotherapy. In about a quarter of study subjects, mesothelioma tumors shrunk.
Scientists are hopeful that a combination of Keytruda and Tumor Treating Fields will be even more powerful.
Two Promising Therapies: Tumor Treating Fields
Tumor Treating Fields is an electrical device that sticks on the chest. Patients wear it all day. It delivers low-intensity alternating electrical fields. These fields make it harder for mesothelioma cells to divide and spread.
Ninety-seven percent of mesothelioma patients tested had some level of disease control with TTFields. Patients lived an average of six months longer than expected. The FDA approved the device as a Humanitarian Device for asbestos cancer in 2019.
Merck makes Keytruda and Tumor Treating Fields is a product of Jersey-based Novocure.
Trial Will Combine Keytruda and Tumor Treating Fields
The first trial of this combination is for patients with PD-1 positive non-small cell lung cancer. The phase 2 pilot study will enroll 66 patients with advanced or metastatic NSCLC. They will measure how many patients respond, how long they live, and if they have complications.
Research shows that TTFields stimulates the immune system. The theory is that cancer cells will be exposed by Keytruda and Tumor Treating Fields will activate the immune system to attack them.
“Multiple preclinical studies suggest that the use of Tumor Treating Fields together with anti-PD-1 therapy can potentially augment the immune response resulting in improved tumor control,” said William Doyle, Novocure’s Executive Chairman in a statement. “We look forward to generating clinical data demonstrating the effect of Tumor Treating Fields concurrent with KEYTRUDA in first-line NSCLC.”
More than 40 US cancer centers are now approved to offer Tumor Treating Fields therapy.
“Novocure Announces Clinical Trial Collaboration with MSD to Evaluate Tumor Treating Fields Together with KEYTRUDA® (pembrolizumab) in Non-Small Cell Lung Cancer”, July 15, 2020, Novocure Website