A daily pill could cut lung cancer deaths in half, new study shows

A once-daily pill cut the risk of death in half for a subset of patients with early-stage lung cancer who had undergone surgery. The results of a new clinical trial were presented on June 4 at the American Society of Clinical Oncology’s annual meeting and were published in the New England Journal of Medicine.

[Related: Poor lung cancer screening guidelines miss too many African American smokers.]

The pill named osimertinib and sold under the brand name Tagrisso is manufactured by drugmaker AstraZeneca, who funded the study. The pill is directed at a specific receptor that helps cancer cells grow. 

The study included a 682-patient trial that included patients diagnosed with non-small cell lung cancer, which is one of two main types of primary lung cancer that makes up 80 to 85 percent of all lung cancers. The participants in the study also had a mutation in the epidermal growth factor receptor (EGFR) gene. This gene codes for a protein that is found on the surface of cells. EGFR mutations can increase cancer’s ability to grow and spread throughout the body, which increases a patient’s risk of cancer recurrence after completing treatment. 

Roughly 10 to 15 percent of lung cancer cases in the United States have an EGFR mutation, however it is more common in Australia and Asia. The mutation is usually detected in those with little to no history of smoking. About two-thirds of the trial participants had no history of smoking, suggesting that it works for smokers and non-smokers diagnosed with lung cancer.

Osimertinib generally works by blocking the effects of these common EGFR mutations.

According to the results, five years after their diagnosis, 88 percent of those who took osimertinib were still alive, compared to 78 percent of the placebo group. The pill lowered the overall risk of death from lung cancer by 51 percent. This data is reportedly the first to show how targeted treatment for early-stage lung cancer can impact patient survival.

“Thirty years ago, there was nothing we could do for these patients,” study co-author and deputy director of Yale Cancer Center Roy Herbst said, according to The Guardian. “Now we have this potent drug. Fifty percent is a big deal in any disease, but certainly in a disease like lung cancer, which has typically been very resistant to therapies.”

[Related: 100 Years Of Smoking Studies In Popular Science.]

Over 100 countries have already approved osimertinib under the brand name Tagrisso, including the United States. The Food and Drug Administration (FDA) approved it in 2015 for those with more advanced lung cancer whose diseases worsened during or after other cancer treatments. In 2020, the FDA approved Tagrisso for early-stage versions of lung cancer.

Patrick Forde, an associate professor of oncology at Johns Hopkins Medicine who was not involved in the study told NBC News that before targeted treatments like Tagrisso were available, patients diagnosed with stage 1 to 3 lung cancer would typically receive chemotherapy after surgery. He estimated that the treatment would improve odds of survival by roughly five percent compared to those who did not receive chemo. 

“If you go back 15 years, for this patient population we would have expected maybe a survival of 50 percent at five years,” he said. “But because of the advances both for stage 4 cancer, and now this advance in earlier stage cancer, we’re up to 88 percent.”

Forde has consulted for AstraZeneca and obtained research funding from the drug company in the past.
Lung cancer accounts for about 1.8 million deaths per year and is the world’s leading cause of cancer death. More than 127,000 Americans die from lung cancer, according to data from the American Cancer Society.