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Combining two immunotherapies improves life expectancy in thyroid cancer


The combination of two immunotherapy drugs can reach double life expectancy in patients with a kind of aggressive thyroid cancer without therapeutic alternatives, According to the results of a trial sponsored by the Spanish Group of Neuroendocrine Tumors (GETNE).

Neuroendocrine tumors, as is the case of the thyroid, are rare cancers that can appear anywhere in the body and also have a very different behaviour: some of them grow slowly while others grow very quickly.

At the annual congress of the European Society of Medical Oncology (ESMO), which is being held these days in Paris, the results of a study, sponsored by GETNE, that addresses the case of some advanced thyroid tumors that are refractory to conventional treatments.

Patients who suffer from them have a life expectancy between three and six months and they are currently orphaned of therapeutic alternatives.

The immunotherapy has been a real revolution in cancer treatment, but to date the standard therapy for these cases, which consists of inhibiting PD-L1 (a protein that acts as a brake on the body’s immune response and is present in higher amounts in some cancer cells), has had limited effectiveness.

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However, the researchers noted that if this treatment was combined with another immunotherapy, the landscape changed.

“In preclinical research it was observed that with the combination of a PD-L1 inhibitor immunotherapy with a CTLA-4 -T cell protein that helps keep immune responses under control – both were enhanced, with a synergistic effect”, explained Dr. Jaume Capdevila, president of GETNE and researcher at the Vall d’Hebron Institute of Oncology (VHIO).

Hence, the researchers decided to launch the duthy studio 1, a phase II clinical trial evaluating the safety and efficacy of a combination of durvalumab, a monoclonal antibody that binds to the PD-L1 protein to help immune cells kill more cancer cells, and tremelimumab, another antibody but that targets the CTLA-4 protein, contributing to the activation of T cells to attack cancer cells.

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Participating in the study 68 patients, divided into three groups based on the type of thyroid tumor they had: differentiated carcinoma, medullary carcinoma and anaplastic cancer.

In the first two types, patients had to have received at least two previous lines of treatment, while this was not necessary in patients with anaplastic cancer, as it is the most aggressive type, without any type of treatment approved today that improves survival.

“What we have been able to observe is that in all the groups a survival that managed to exceed the year and this is very important if we take into account that we are talking about very pre-treated patients, who do not currently have any alternative”, Dr. Capdevila has highlighted.

The results are “especially striking” in anaplastic thyroid cancer, “that double the hope in life”, the researcher added.

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