5 Developments With Cancer Immunotherapy
There’s a lot happening in clinical practice with immunotherapy treatments: expanded indications for nivolumab and ipilimumab, biomarkers to judge patient response to combinations, and developments with CAR-T.
There’s a lot happening in clinical practice with immunotherapy treatments. Following are a few notable highlights:
1. Nivolumab in colorectal cancer
Although the programmed death-1 (PD-1) inhibitor nivolumab (Opdivo from Bristol-Myers Squibb [BMS]) has significantly trailed behind its competitor, pembrolizumab (Keytruda from Merck)—especially after nivolumab
A recent success for nivolumab is its
The CheckMate-142 trial, being conducted across 31 sites in 8 countries, noted an objective response rate of 28% in patients who had received a prior treatment with a fluoropyrimidine, oxaliplatin, or irinotecan. Thirty-two percent of the overall population responded to treatment, which included a 30% partial response.
2. Pediatric indication for ipilimumab
An early entrant in clinical practice, the cytotoxic T-lymphocyte associated protein 4 inhibitor ipilimumab (Yervoy from BMS) was the first checkpoint-inhibitor immuno-oncology agent to be
Yervoy was evaluated in 2 trials—a dose-finding study with 33 patients between the ages of 2 and 21 years old with relapsed or refractory solid tumors, and an open-label, single-arm trial in 12 patients between the ages of 12 and 16 years old with previously treated or untreated, unresectable stage 3 or 5 malignant melanoma—and demonstrated equivalent safety to the use of Yervoy in adults.
3. Ensuring patient response to combination immunotherapy in melanoma
With clinical trials evaluating several different combinations of immunotherapy agents, can we use predictive biomarkers as an early sign of patient response? A
Patients with low peCTL who were given combination therapy showed higher overall response rates (ORR) than patients who received the monotherapy, while in patients with high peCTL, ORR to anti-PD-1 monotherapy and combination therapy were similar. The authors concluded that fewer tumor-infiltrating peCTLs may be necessary to achieve a response to combination immunotherapy.
4. CAR-T cell progress in DLBCL
Kite Pharma’s anti-CD19 chimeric antigen receptor-T (CAR-T) cell treatment has resulted in remission for up to 56 months in patients with diffuse large B-cell lymphoma (DLBCL). The results from a long-term study in 7 evaluable patients with relapsed DLBCL who received the anti-CD19 CAR-T cells were published in
These study results are encouraging news for this potentially revolutionary treatment, which has seen some setbacks in recent times. Juno Therapeutics had to
5. ODAC approval for CAR-T
A giant step forward in the field of immunotherapy was the recent FDA Oncologic Drugs Advisory Committee (ODAC)'s
Of course, neurological toxicity and cytokine release syndrome being a big concern with CAR-Ts, Novartis has developed a Risk Evaluation and Mitigation Strategy, which includes ways to communicate treatment-associated risks to providers and patients.
The final decision on CTL019 is expected in October.
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