Researchers at Brigham and Women's Hospital running the CANTOS trial had enrolled more than 10,000 heart attack survivors to see if blocking a single inflammatory protein, interleukin-1 beta, prevented second heart attacks. Along the way, they tracked something they had not set out to study.
Patients on the highest dose of canakinumab developed 67 percent fewer lung cancers than those on placebo, and lung cancer deaths fell by 77 percent. The signal came out of a trial built to study arteries, not tumors, testing whether the same chronic inflammation drives both heart disease and certain cancers.
Ridker's team called the result hypothesis-generating rather than proof, since CANTOS was never designed or powered as a cancer trial, and the finding came from a subgroup. It pointed toward interleukin-1 beta as a possible shared driver of atherosclerosis and lung cancer, and follow-up cancer-focused trials of anti-inflammatory drugs began. Canakinumab itself was not pursued for lung cancer, in part because of its cost and infection risk.
Read the original study
Ridker et al., The Lancet, 2017 · doi.org/10.1016/S0140-6736(17)32247-X
A heart trial stumbled onto cancer.
Source
- Ridker, P. M., MacFadyen, J. G., Thuren, T., Everett, B. M., Libby, P., Glynn, R. J., Ridker, P., Lorenzatti, A., Krum, H., Varigos, J., Siostrzonek, P., Sinnaeve, P., Fonseca, F., Nicolau, J., Gotcheva, N., Genest, J., Yong, H., Urina-Triana, M., Milicic, D., . . . Glynn, R. J. (2017). Effect of interleukin-1β inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: exploratory results from a randomised, double-blind, placebo-controlled trial. The Lancet, 390(10105), 1833–1842. https://doi.org/10.1016/S0140-6736(17)32247-X