Immunotherapy

Chicago, IL—Immunotherapy holds promise as second-line or third-line treatment of patients with malignant pleural mesothelioma, a rare cancer with increasing incidence. Early findings from the ongoing, phase 2 MAPS-2 clinical trial showed that immunotherapy slowed the growth of malignant pleural mesothelioma after relapse, reported lead investigator Arnaud Scherpereel, MD, PhD, Head, Pulmonary and Thoracic Oncology Department, University Hospital of Lille, France, at the 2017 ASCO annual meeting. MAPS-2 is the largest clinical trial to date of immune checkpoint inhibitor therapy in patients with malignant pleural mesothelioma.

Chicago, IL—The tumor types amenable to immunotherapy with the PD-1 inhibitor pembrolizumab (Keytruda) keep expanding and now include sarcoma, which has been difficult to treat.

Chicago, IL—Chimeric antigen receptor (CAR) T-cell therapy is changing cancer care. In 2010, there were just 3 CAR T-cell clinical trials. As of May 2017, 183 clinical trials are underway, and for the first time, there are more clinical trials in China than in the United States, according to Carl H. June, MD, Director, Translational Research Program, University of Penn­­sylvania, Philadelphia, at the 2017 ASCO annual meeting. Dr June discussed how this rapidly evolving technology is taking immuno-oncology to the “next level” of precision medicine.

Washington, DC—In the longest follow-up on single-agent nivolumab (Opdivo) to date, 5-year overall survival was 16% in patients with advanced non–small-cell lung cancer (NSCLC) in the updated results of a phase 1b dose-ranging study (CA209-003). This represents a quadrupling of 5-year overall survival with standard platinum doublets, which is approximately 4% for patients with metastatic NSCLC.

Orlando, FL—Enthusiasm for immunotherapy in the treatment of cancer must be balanced with a healthy respect for the power of T-cell activation. Autoimmunity is recognized as an effect of prolonged T-cell activation via PD-1/PD ligand 1 inhibition. Although immune-­related adverse events are generally easily managed, they occasionally can be fatal and therefore should be managed without delay, said Stephanie Andrews, MS, ANP-BC, a hospitalist specializing in medical oncology at Moffitt Cancer Center, Tampa, FL, at the 2017 National Comprehensive Cancer Network (NCCN) annual conference.

National Harbor, MD—Platinum-resistant ovarian cancer also appeared resistant to the immunotherapeutic effects of the toll-like receptor 8 (TLR8) agonist motolimod as add-on to chemotherapy, according to results of a randomized trial.

Washington, DC—Adding the investigational drug indoximod, an indole­amine 2,3-dioxygenase (IDO) pathway inhibitor, to the checkpoint inhibitor pembrolizumab (Keytruda) led to higher response rates in patients with advanced melanoma than what is reported with pembrolizumab monotherapy, said lead investigator Yousef Zakharia, MD, Clinical Assistant Professor of Internal Medicine, Division of Hema­tology, Oncology and Blood and Marrow Transplantation, University of Iowa, Iowa City, at the 2017 American Association for Cancer Research meeting.

Orlando, FL—Atezolizumab plus bevacizumab showed encouraging responses as a first-line treatment of metastatic renal-cell carcinoma in a phase 2 trial. Although the trial failed to meet its primary end point of significant improvement in progression-free survival (PFS) compared with sunitinib, the combination did reduce the risk for death or disease progression by 36% in patients with elevated PD ligand 1 (PD-L1) expression. The median PFS was almost double in the PD-L1–positive group with atezolizumab plus bevacizumab versus sunitinib (14.7 months vs 7.8 months, respectively).

Orlando, FL—Immunotherapy is now an established option for patients with non–small-cell lung cancer (NSCLC) in the second-line setting and in selected patients in the first-line setting.

National Harbor, MD—Results of a phase 1/2 study that investigated 2 dosing regi­mens of 2 immunotherapies—the PD-1 inhibitor nivolumab (Opdivo) plus the CTLA-4 inhibitor ipilimumab (Yervoy)—in patients with previously treated metastatic urothelial carcinoma showed higher response rates and longer median overall survival with the regimen of nivolumab 1 mg/kg plus ipilimumab 3 mg/kg than with the dosing of nivolu­mab 3 mg/kg plus ipilimumab 1 mg/kg.