A cost-effective anti-angiogenic drug to treat lung cancer is finally here

In 2018, lung cancer caused 1.8 million cancer deaths worldwide. It is the most common type of cancer, with non-small cell lung cancers (NSCLCs) accounting for 85% of lung cancers. Most recent lung cancer research focuses on anti-angiogenic therapy, a cancer treatment that uses anti-cancer drugs to block the tumor’s angiogenesis, enabling them to fight cancer. One such well-known anti-cancer drug is bevacizumab, which was approved by the FDA in 2006 for the treatment of NSCLC.

Bevacizumab is what is known as an “anti-angiogenesis agent,” which plays an important role in preventing the progression of the disease. However, bevacizumab is expensive, thereby putting a huge financial strain on healthcare systems in many countries, including China. This makes cost-effective bevacizumab analogs, such as the new drug QL1101, highly desirable. A recent study published in Cancer Biology & Medicine, led by Prof. Baohui Han from Shanghai Chest Hospital (China) investigates the efficacy and safety of QL1101 as compared to bevacizumab. According to Prof. Han, “We’re hopeful that QL1101 will reduce the therapeutic cost burden for patients with NSCLC.”

Although QL1101 is known to have similar tumor-inhibiting behavior to bevacizumab, no studies had compared the safety and efficacy of the two drugs until now. In this study, Prof. Han and his team enrolled over 500 Chinese patients with untreated advanced non-squamous NSCLC in a double-blind, phase 3 clinical trial. They randomly divided the patients into two groups: one treated with QL1101 and the other with bevacizumab. They administered these drugs in combination with two standard chemotherapy drugs: paclitaxel and carboplatin. They then followed up with the patients over 18 months and compared the data from both groups. They found that the tumor objective response rate (a measure that assesses the size of the tumor) was 53% in patients who took QL1101 and 57% in those who took bevacizumab. Moreover, overall survival and disease control were also similar in the two groups.

The scientists then divided the groups into subgroups to check the efficacy of the drug for patients with certain clinical characteristics, such as a history of smoking and a mutation in the epidermal growth factor receptor (EGFR) gene. Although an EGFR mutation causes tumors to spread faster, the researchers found that patients with EGFR mutations who took QL1101 or bevacizumab had an overall better survival. The outcomes of the clinical trial were comparable for both drugs across subgroups as well. Finally, they evaluated the data for adverse reactions to the drugs and saw that both drugs had a similar safety profile. These results prove that QL1101 is as safe and effective as bevacizumab, making it a suitable alternative drug in non-squamous NSCLC treatment.

Although several bevacizumab analogs exist, QL1101 is the first one to be approved by the National Medical Products Administration (China). “This study demonstrates that China has made a series of achievements in the field of anti-angiogenic agents, especially macromolecular monoclonal antibodies like the bevacizumab-biosimilar QL1101,” says Prof. Han.

Anti-angiogenic therapy could be a powerful treatment option for patients with lung cancer. Drugs like QL1101 can contribute to long-term survival in patients with advanced lung cancer and even provide a way for lung cancer to be managed as a chronic ailment. An optimistic Dr. Han concludes, “From production to clinical practice, QL1101 provides a cost-effective option for the treatment of non-small cell lung cancers.”

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Reference

Authors: Tianqing Chu¹, Jun Lu¹, Minghong Bi², Helong Zhang³, Wu Zhuang⁴, Yan Yu⁵, Jianhua Shi⁶, Zhendong Chen⁷, Xiaochun Zhang⁸, Qisen Guo⁹, Quan Liu¹⁰, Huijuan Wu¹¹, Jian Fang¹², Yi Hu¹³, Xiuwen Wang¹⁴, Cuicui Han¹⁵, Kai Li¹⁶, and Baohui Han¹

Title of original paper: Equivalent efficacy study of QL1101 and bevacizumab on untreated advanced non-squamous non-small cell lung cancer patients: a phase 3 randomized, double-blind clinical trial

Journal: Cancer Biology & Medicine 

DOI: https://doi.org/10.20892/j.issn.2095-3941.2020.0212

Affiliations:

¹ Shanghai Chest Hospital, Shanghai Jiao Tong University, China

²The First Affiliated Hospital of Bengbu Medical College, China

³ Tangdu Hospital, Air Force Medical University of PLA, China

⁴Fujian Medical University Cancer Hospital, China

⁵Harbin Medical University Cancer Hospital, China

⁶Linyi Cancer Hospital, China

⁷The Second Hospital of Anhui Medical University, China

⁸The Affiliated Hospital of Qingdao University, China

⁹Shandong Cancer Hospital Affiliated to Shandong University, China

¹⁰Affiliated Hospital of Jiang Nan University, China

¹¹Henan Province Tumor Hospital, Zhengzhou University, China

¹²Peking University Cancer Hospital and Institute, China

¹³Chinese PLA General Hospital, China

¹⁴Qilu Hospital of Shandong University, China

¹⁵Qilu Pharmaceutical Co., Ltd, China

¹⁶Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, China

About Professor Baohui Han

Professor Baohui Han is the Deputy Director of Shanghai Chest Hospital (China). With over 30 years of experience, he is a leading expert in the field of respiratory medicine. His research interests are lung cancer immune therapy, anti-angiogenic therapy, targeted therapy and other antitumor drugs. As an executive committee member of the China Anti-Cancer Association, he has published over 200 papers on lung cancer and has conducted numerous domestic and international clinical trials. Prof. Han has also won the Shanghai Municipal Health Bureau Award for Science and Technology Progress for his research.