Immunotherapy

Immunotherapy

The National Comprehensive Cancer Network’s first guideline for the management of side effects from immunotherapy recognizes “a new spectrum of adverse events” in patients who are receiving immune checkpoint inhibitor therapy, said John A. Thompson, MD.

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.

“The combination of atezolizumab and cobimetinib represents the first potential immune-modifying combination for patients with microsatellite stable metastatic colorectal cancer,” said Johanna C. Bendell, MD, at the 2018 Gastrointestinal Cancers Symposium.

As the number of patients receiving immune checkpoint blockade grows, the combination of radiation and immunotherapy has become increasingly relevant, particularly in the palliative care setting, where radiation therapy is used to treat painful lesions or brain metastases.

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.
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