Pill for ‘death star’ lung cancer not caused by smoking

Thousands more NHS patients with a deadly type of lung cancer are to benefit from a drug hailed as the biggest treatment breakthrough in decades.

Sotorasib is a daily tablet that has been proved to shrink tumours in half of patients with advanced lung cancers not caused by smoking.

This type, which affects one in eight lung-cancer sufferers, is caused by a mutation in a gene known as KRAS.

It is a particularly lethal form of cancer for which current treatments are effective in only about ten per cent of sufferers.

In a healthy body, the KRAS gene controls proteins that play a part in normal cell growth. But mutated KRAS genes allow the proteins to instruct cells to grow out of control, causing a cancer that is notoriously hard to treat.

Such is the mutated gene’s cancer-causing power that medics have labelled it cancer’s ‘death star’.

The same mutation can also be found in some cases of pancreatic and bowel cancer, raising hopes that sotorasib will be able to help many more patients in the future.

Previously sotorasib was available only NHS patients as part of a limited trial.

But now anyone who needs it – expected to be at least 600 more people a year – are set to benefit after the NHS negotiated a discount with US drug-maker Amgen.

‘This drug is one of the most exciting breakthroughs in lung cancer in 20 years,’ says Professor Charles Swanton, an expert in genetics and lung cancer at the Crick Institute in London.

‘And it will improve survival for patients with limited options. Nearly half of those on it see their tumours shrink, compared to less than ten per cent with some drug treatments.’

Lung cancer is Britain’s third most common form of the disease, with an estimated 48,000 new cases every year.

Smoking, or a recent history of smoking, is by far the biggest cause, but the disease can still strike those who may never have touched a cigarette.

In the 1980s, scientists first identified that a significant proportion of these cases were caused by a mutant form of the KRAS gene, but solving the puzzle of how to combat that defect has taken decades of intensive research.

Sotorasib, also know by the brand name Lumykras, works by blocking the action of the proteins that trigger cancerous cell growth.

This helps to stop, or at least slow, its spread.

Currently the drug is being offered only to patients who have exhausted all other treatment options and where the cancer has spread elsewhere in their body.

But the hope is that sotorasib may in future be used at an earlier stage, potentially boosting long-term survival rates.

Dr Noor Tariq, a specialist at the Clatterbridge Cancer Centre in Liverpool, says: ‘Results so far have been amazing. The next question is will it work even better if used earlier on in the treatment process? That’s being looked at in trials now and we are excited to see what they show.’

Nicky Peel, 53, from Brecon in Powys, was one of the first lung-cancer patients in the UK to be given sotorasib.

She was diagnosed with the disease in 2017, after spending months ‘waking up feeling like I couldn’t breathe’.

‘It was such a terrible shock – you never think it is going to happen to you,’ she says. ‘I was told my life expectancy at that point was about 12 to 18 months.’

Nicky, an IT manager, underwent gruelling chemotherapy and radiotherapy, followed by treatment with a drug to turbo-charge her immune system to fight the cancer cells.

But in January 2018, scans showed that the cancer had spread to her spine and hips while the lung tumours had kept growing.

She then asked her oncologist at the NHS Velindre Cancer Centre in Cardiff if she could be put on sotorasib.

‘I’d read online that the drug was having good results in American patients with my type of cancer,’ says Nicky.

Her consultant applied for funding on compassionate grounds and Nicky began taking the drug in December last year – initially just half the recommended eight tablets a day in case of liver damage, one of its recognised side effects.

A few weeks later, when her liver tests came back clear, she was switched to the full dose.

‘I was hoping it would just stabilise my cancer, but when I had my first scan in January it showed the tumours on my lung had shrunk by about a third,’ says Nicky.

‘I couldn’t believe it – it was too good to be true. None of my previous treatments managed to shrink the tumours. And apart from some slight bone and muscle pain, I was free of side effects.’

Nicky admits she has no idea if the drug will continue keeping her cancer at bay. But she adds: ‘It is giving me more precious time to spend with the family and is allowing me to live my life in full – not just to survive.

‘I want to be able to have a good quality of life, and sotorasib is helping me do that.’