Immunotherapy
Learning how to activate and harness the immune system—the body’s built-in defense against disease—has brought the field of oncology to the cusp of a cure for at least some, if not many, types of cancer, according to an international authority in immuno-oncology.
The CAR product “is essentially an autologous T-cell, which is transduced using a lentiviral encoding vector for a CAR, which is specific to human BCMA,” said Dr Raje. The co-stimulatory domain that includes 4-1BB is believed to be associated with durable CAR T-cell persistence compared with the CD28 co-stimulatory domain.
Learning how to activate and harness the immune system—the body’s built-in defense against disease—has brought the field of oncology to the cusp of a cure for at least some, if not many, types of cancer, according to an international authority in immuno-oncology.
The NCCN’s first guideline for side effects from immunotherapy recognizes a new spectrum of events in patients who are receiving immune checkpoint inhibitor therapy.

Chimeric antigen receptor (CAR) T-cell therapy has had excellent results in late-stage leukemia and varying degrees of success in some other hematologic cancers, but thus far, solid tumors have not responded to this therapy.

Among the 84 patients, 7 had partial responses with the combination of atezolizumab (Tecentriq) and cobimetinib (Cotellic). The median duration of response was 14.3 months.

The combination cohort consisted of 119 patients who received nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks for 4 doses followed by nivolu­mab 3 mg/kg every 2 weeks. The median follow-up was 13.4 months.

“We find that T-cells with highly activated glycolysis pathways ended up performing worse when we tried to make them into CAR T-Cells. Substituting and supplementing heavily with fatty acids did seem to improve this a little,” said David M. Barrett, MD, PhD, at the 2018 American Association for Cancer Research annual meeting.

The FDA granted accelerated approval to nivolumab based on a notable clinical benefit in a subset of patients who progressed after receiving the standard first-line chemotherapy with fluoropyrimidine, oxaliplatin, and irinotecan.

Interim data from a recent clinical trial of nelipepimut-S plus trastuzumab showed a disease-free survival advantage compared with trastuzumab alone in patients with HER2 1+/2+ breast cancer.

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