The details of the additional CANTOS lung cancer findings were also presented at ESC and simultaneously published in The Lancet. It’s a medication that reduces inflammation, the body’s response to injury. For two decades, he’s been researching the role of inflammation in heart disease. However, both Libby and Ridker have not established if statins’ anti-inflammatory ability contributes in protecting heart function.
While the effects were observed to be dose-dependent, Novartis reported that treatment with ACZ885 reduced the relative risk of lung cancer by 67% and lung cancer mortality by 77%. Not all anti-inflammatory drugs passed their criteria so they narrowed their search to canakinumab, a drug normally applied for arthritis and other inflammatory syndromes. By inhibiting the cytokine through ACZ885, the CANTOS study aimed to determine whether the drug could stop the progression of cancer.
Participants in the trial received 50 mg, 150 mg or 300 mg of canakinumab or a placebo, injected subcutaneously every hree months.
With more than 10,000 patients enrolled in the study over the last six years, CANTOS was one of the largest and longest-running clinical trials in Novartis’ history.
Canakinumab works by targeting an interleukin involved in the inflammatory pathway, which has been associated with increased risk of cardiovascular events in previous research.
Patients who received the highest dose of the drug (300 mg) had approximately half the rate of total cancer deaths and one-quarter the rate of fatal lung cancer compared to those who received the placebo.
But despite these figures, and although there was a double-digit drop in heart attacks, the percentages remain modest. It should be noted that a second, federally funded trial of an old, cheap but less targeted anti-inflammatory drug called Methotrexate is also underway.
Novartis revealed primary data from CANTOS, a phase III study evaluating quarterly injections of ACZ885 (canakinumab) in people with a prior heart attack and inflammatory atherosclerosis as measured by high-sensitivity C-reactive protein (hsCRP) levels of =2mg/L, a known marker of inflammation.
Doctor Paul Ridker of Brigham and Women’s Hospital led the study.
“These data are a significant milestone because they show that selectively targeting inflammation with ACZ885 reduces cardiovascular risk and that ACZ885 may also be an important immuno-oncology therapy targeting IL-1ß for lung cancer”, said Vas Narasimhan, Global Head, Drug Development and Chief Medical Officer, Novartis.
“This has far-reaching implications”, Ridker said.
The study suggested that by leveraging this new way to treat patients, targeting inflammation, it is possible to significantly improve results for certain very high-risk populations.