Stock picture of ashtray with cigarettes in it.

A study has shown that a new, innovative approach to lung cancer treatment in which immunotherapy is administered prior to surgery is yielding encouraging outcomes in 45 % of non-small cell lung cancer patients treated. 

In a study published on Monday in the New England Journal of Medicine, Scientists at Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy and Memorial Sloan Kettering Cancer Center administered two doses of the anti-PD1 immunotherapy nivolumab for several weeks prior to surgery. 

The therapy turned out to be not only safe but 45 % of the patients in the initial trial responded so well that there was little evidence of the cancer remaining upon follow-up.

 According to the researchers, the patients' immune systems also likely destroyed straggler tumor cells still circulating in the blood system, which can later take hold and lead to recurrence and metastasis. "The team is using T cells, activated by immunotherapy prior to surgery, to continue to circulate through the patient's body, after surgery. 

These T cells can intervene, stopping errant tumor cells from forming new metastases, preventing recurrence," said Sung Poblete, CEO of Stand Up To Cancer, a foundation that funded the research.

Previously, chemotherapy or chemoradiotherapy is given to lung cancer patients to shrink a large, non-metastasized tumor while immunotherapeutic agents have been administered after surgery with limited results. 

However, the researchers hypothesized that leaving the tumor in place during initial treatment with immunotherapy would turn it into an "auto-vaccine." The "auto-vaccine" might result in the activation of tumor-specific T cells that would then circulate through the body and find distant sites of micrometastases, thereby preventing relapse post-surgery which can happen to at least one-half of lung cancer patients who undergo surgery. After a median follow-up of 12 months, three-quarters of the patients who underwent surgical resection were alive and recurrence-free. Recurrence-free survival at 18 months was 73 percent. Enditem