Results from a trial on the use of the monoclonal antibody canakinumab in heart disease has failed to impress, but an exploratory analysis suggests it may have a role in lung cancer.
The trial was not designed to explore the benefits of cancer, but the fact that a mortality benefit from cancer was observed may overshadow the more modest cardiovascular results.
“CANTOS provides the first evidence from a randomised trial in human beings that inhibition of interleukin 1β with the monoclonal antibody canakinumab is associated with reduced incidences of fatal cancer, lung cancer, and fatal lung cancer,” the authors wrote in the Lancet.
But, they cautioned, their “data should be interpreted in the context that the primary aim of the trial was to investigate cardiac events rather than cancer events…. Our exploratory data should be replicated and extended in settings directly related to early cancer screening and initial treatment of cancers, particularly lung cancer.”
Over the course of the study there were 196 cancer deaths. Compared to placebo there was a 14% reduction in the 50 mg group, a 22% reduction in the 150 mg, and a 51% reduction in the 300 mg group.
The reduction in the 300 mg group achieved statistical significance, though the authors cautioned about the use of statistical tests in an exploratory analysis.
Nearly all the benefit occurred in lung cancer. Incident lung cancer was reduced by 23% in the 50 mg group, 39% in the 150 mg group, and 67% in the 300 mg group. Fatal lung cancer was reduced by 77% in the 300 mg group.
The authors speculated that canakinumab didn’t prevent cancer from starting but said that “a more biologically plausible explanation is that canakinumab reduced the rate of progression, invasiveness, and metastatic spread of lung cancers that were prevalent but undiagnosed at trial entry.”
This article has been republished from Larry’s blog CardioBrief as part of a licensing agreement between Everyday Health and the limbic.