IMMUNOTHERAPY

During a Targeted Oncology Case Based Peer Perspectives event, John Heymach, MD, PhD, professor and Chair, David Bruton Jr Chair in Cancer Research. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, discussed the guidelines and therapeutic option for stage III non–small cell lung cancer, based on a case of a 66-year-old patient.

The oral small molecule FLX475 demonstrated promise when administered either alone or in combination with the immune checkpoint inhibitor pembrolizumab in multiple solid tumors, according to findings from a phase 1/2 dose-escalation and expansion study.

Tumor mutational burden has been correlated with response to immunotherapy use in patients treated with immune checkpoint blockade. However, use of this biomarker has been challenged along the way with various criticisms of validity and routine use.

In an interview with Targeted Oncology, Laurence Albiges, MD, PhD, discussed the updated findings for the combination of nivolumab and ipilimumab as treatment of patients with intermediate- and poor-risk advanced renal cell carcinoma.

Natalie I. U. Vokes, MD, discusses the future of predicting how patients will respond to treatment, especially immunotherapy, based on their genomic profile.

An analysis of patient samples from The Cancer Genome Atlas indicated a possible connection between tumor responses to immunotherapy and patient baseline characteristics after investigators discovered evidence of stronger immune selection by female and younger patients in early tumorigenesis.

Results from the study, JAVELIN Bladder 100, demonstrated that in patients who have achieved stable disease or better after first-line platinum-based chemotherapy, maintenance avelumab significantly improved both progression-free survival and overall survival compared with best supportive care alone.

In patients with advanced melanoma whose disease progressed on immunotherapy, the use of fecal microbiota transplant achieved objective responses, in a phase I study.

Sylvia Adams, MD, discusses the synergy between anti-CTLA4 and anti-PD-L1 antibodies as treatment of patients with breast cancer.

“RO7198457 in combination with atezolizumab induced immune responses in the majority of patients, including preliminary data demonstrating the detection of neoantigen-specific T-cell responses within the tumor."

The study showed that the development of immune-related adverse events in advanced solid tumors was positively correlated with improved progression-free survival and overall survival in a retrospective analysis, which also showed that Caucasian patients developed immune-related adverse events more frequently than African American patients.

Karen Kelly, MD, discusses how oncogenic drivers affect the use and placement of immunotherapy for patients with lung cancer.

A study found correlation between body mass index in patients with non–small cell lung cancer treated with atezolizumab and improved survival outcomes.

Jamie E. Chaft, MD, discusses biomarkers used to identify patients with lung cancer who would benefit from immunotherapy and the possibility for future biomarkers in this setting.

“We don’t have a good understanding of why some patients have a robust response to immunotherapy and others do not. That’s important, not only in terms of selecting patients but also in terms of the therapy approach. This is one reason why clinical trials are incredibly important.”

Joshua Brody, MD, discusses how he sees the use of immunotherapy evolving in coming years.

Prasad S. Adusumilli, MD, FACS, discusses where he sees chimeric antigen receptor T-cell therapy fitting into the treatment landscape for patients with solid tumors.

Treatment with sacituzumab govitecan resulted in “compelling evidence of efficacy” in patients with metastatic triple-negative breast cancer, leading to an early halt of the phase III ASCENT study, announced Immunomedics in a press release.

Durable remissions were elicited with KTE-X19 in a majority of patients with relapsed or refractory mantle cell lymphoma, according to the updated results from the ZUMA-2 trial published in the New England Journal of Medicine. The treatment did, however, cause serious adverse events that were consistent with known toxicities of chimeric antigen receptor T-cell therapy.

In an interview with Targeted Oncology, Prasad S. Adusumilli, MD, FACS, discussed the expansion of chimeric antigen receptor T-cell research in the solid tumor space and the challenges researchers will need to overcome in order to make this therapy effective for patients outside of the hematologic treatment landscape.

Jonathan C. Trent, MD, PhD, discusses some of the recent immunotherapeutic advances in the treatment landscape for patients with sarcoma, particularly with immune checkpoint inhibitors.

GEN-1 immunotherapy demonstrated dose-dependent efficacy results in newly diagnosed patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer when treated in combination with the standard of care, according to results from the OVATION 2 study. Based on positive data in the phase I portion, the study is moving on to phase II with enrollment expected to begin in the second half of the year.

Microsatellite instability has been an FDA-indicated biomarker for immunotherapy since 2017, when the PD-1 inhibitor pembrolizumab was approved for patients with solid tumors found to be mismatch repair deficient or MSI high. Other approvals since then, such as for the combination of ipilimumab and nivolumab in patients with MSI-H/dMMR metastatic colorectal can­cer, have established the relevance of cancer thera­pies for tumors with this biomarker specifically rather than tumor histology alone.

David Miklos, MD, PhD, describes the toxicity profile of KTE-X19, a chimeric antigen receptor T-cell therapy, in the ZUMA-2 trial.

In an interview with Targeted Oncology at the 2020 International Congress on Hematologic Malignancies, Noopur Raje, MD, discussed emerging CAR T-cell therapies in multiple myeloma. She also explained how CAR NK cells differ from other CAR agents.