INTERVIEW
The great global and annual meeting of oncology, ASCO, has just ended with a virtual 2020 edition, Covid-19 obliges. Professor Christophe Le Tourneau, oncologist specializing in innovation at the Curie Institute, responsible for early clinical trials, explains on Europe 1 the different advances in the treatment of this disease which affects nearly 380,000 people each year in France. The professor noted an advance towards "precision medicine".
>> Find the whole of Sans rendez-vous in replay and podcast here
The remote presentations of the various specialists during the congress made it possible to discover new results in various ongoing studies. "We are progressing more and more towards precision medicine", underlines Christophe Le Tourneau. "There are more and more drugs which are no longer given by type of cancer but on the basis of molecular alteration and which are extremely effective in these small subgroups of patients. Each time, they are drugs which affect only a small group of patients but are very effective in this context. "
Nanoparticles to better treat throat cancer
Christophe Le Tourneau and his team were able to present the second phase of their study to improve the effects of radiotherapy on throat cancer, thanks to the surgeon's injection of nanoparticles directly into the patient's tumor, under general anesthesia. Objective: to increase the efficiency of the shelves, from the inside. "These are nanoparticles which are inert and which, on their own, have no activity. They will only produce their effect when the radiotherapy is going to start, therefore by multiplying the quantity of rays delivered", specifies the oncologist.
>> READ ALSO - Covid-19: twice the risk of death in cancer patients
During the 2019 edition of ASCO, the professor presented his work on the dose of nanoparticle to be administered to patients. This year, it is moving up a gear. "There we presented our results with about fifty patients who were treated all at the same dose, which we identified as being the right one, and these results show that in 83% of the patients we have a very good response to the treatment The idea now is to go to phase 3, that is to say to go to a comparative trial in order to obtain a marketing authorization. " For this third step, half of the patients will receive an injection of nanoparticles and the other half will not receive it to prove the effectiveness of nanoparticles in improving the outcome of patients.
The Mammaprint strategy to fight breast cancer
The ASCO meeting is an opportunity to take stock of all the advances in cancer treatment or screening. Christophe Le Tourneau notably mentioned the "Mammaprint" strategy for breast cancer. "The idea is to try to treat less patients with breast cancer, [at least] for those who do not have metastases," says the professor. "The treatment is heavy with surgery, sometimes chemotherapy, radiotherapy, hormone therapy, and what we are trying to do is reduce the number of patients who are going to have chemotherapy since it is a treatment that is heavy with consequences. "
Mammaprint's strategy is to do a genomic analysis at the tumor level, "so look at the molecular level and see if we could not dispense with chemotherapy in a certain number of patients", specifies the oncologist. "In the group of clinically at risk patients who would have been told: 'chemotherapy should be done there', this has halved the number of these patients who have used chemotherapy."
>> READ ALSO : "50% of couples" do not survive breast cancer, according to specialist Rémi Salmon
Various studies are in progress concerning genomic signatures, in particular on colon cancer to reduce the duration of chemotherapy after surgery from six to three months. "These are extremely long works, we must validate these signatures, show that it allows not to do chemotherapy while maintaining a cure rate," he adds.
Extension of immunotherapy and better management of side effects
Another hope in cancer treatment strategies: immunotherapy, a treatment that will stimulate the immune system of patients so that it destroys tumor cells. The generalization of these treatments is progressing. "We only had marketing authorization on the second or third line after failure of conventional treatments," explains the oncologist. "Now we have marketing authorizations from the first line of recurrence. We also have extensions with new indications such as certain types of lung cancer which are rarer." The most promising remains immunotherapy associations. "There are a lot of trials in progress with results that are long overdue," says Christophe Le Tourneau.
>> READ ALSO - Immunotherapy and targeted therapy: the little revolution in lung cancer treatments
A promising future which will not replace conventional treatments nevertheless reminds Christophe Le Tourneau, because immunotherapy does not work every time. "We know why it works in certain cases, in particular on the basis of the biology of tumor cells, the fact that there are many mutations, etc. But we still have trouble understanding why it does not work in certain patients", he explains. "Classic treatments are important."
Especially since great progress has been made in supporting patients and managing the serious side effects of chemotherapy. "Today we cure around 60% of cancer patients. The goal is to increase this figure," says Christophe Le Tourneau. An increase in healings which will involve advances in terms of treatment, but also of screening: advanced medical imaging, refined and personalized diagnosis.