Anti-inflammatory therapy with canakinumab may result in a significantly lower incidence of lung cancer and lung cancer mortality, according to a study published in the Lancet.
Researchers performed a prospective, randomized, double-blind, placebo-controlled trial (Cardiovascular Risk Reduction Study [CANTOS]; ClinicalTrials.gov identifier: NCT01327846) with 10,061 participants diagnosed with atherosclerosis but not cancer and a history of a myocardial infarction, to examine the effect of inhibiting interleukin-1b on cancer incidence.
Participants were randomly assigned to receive placebo or one of 3 different doses of canakinumab (50 mg, 120 mg, and 300 mg, subcutaneously every 3 months).
Study results demonstrated significantly higher baseline concentrations of high-sensitivity C-reactive protein (hsCRP) and interleukin 6 in participants who were subsequently diagnosed with lung cancer compared with those not diagnosed with cancer (median: 6.0 mg/L vs 4.2 mg/L; P <.0001, and 3.2 vs 2.6 ng/L; P <.0001, respectively). Follow-up at 3.7 years showed dose-dependent reductions in concentrations of hsCRP (26% to 41%) and of interleukin 6 (25% to 43%) in patients treated with canakinumab compared with those treated with placebo (P <.0001 for all comparisons).
Overall cancer mortality (n=196) was lower in those treated with canakinumab compared with placebo (P =.0007), with a significantly lower incidence in participants treated with 300 mg (hazard ratio [HR]: 0.49; 95% CI, 0.31-0.75; P =.0009). Incidence of lung cancer was significantly lower in the 150-mg and 300-mg treatment groups (HR: 0.61; 95% CI, 0.39-0.97; P =.034 and HR: 0.33; 95% CI, 0.18-0.59; P <.0001, respectively).
Investigators concluded that lung cancer and lung cancer mortality might possibly be reduced through anti-inflammatory therapy with canakinumab, which targets the interleukin-1b innate immunity pathway. The effects of canakinumab were dose dependent, with the greatest benefit seen in participants treated with the 300-mg dose.
Ridker PM, MacFadyen JG, Thuren T, Everett BM, Libby P, Glynn RJ. Effect of interleukin-1b inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: exploratory results from a randomized, double-blind, placebo-controlled trial. Lancet. 2017;390(10105):1833-1842.