June 11, 2014
The Promise of Cancer Immunotherapy Continues to Expand:
Highlights from the ASCO 2014 Annual Meeting
The 2014 American Society of Clinical Oncology (ASCO) Annual Meeting picked up where it left off in 2013 with even more promising data presented in the field of cancer immunotherapy. This time, however, even more excitement sorrounds the field as data presented from clinical trials indicate that immunotherapies are working in cancer types where few treatments have been available before. While the five-day conference was packed with even more exciting news for the field of cancer immunotherapy, some brief highlights from the conference are noted below.
Advances in Bladder Cancer
- The treatment of bladder cancer with the anti-PD-L1 antibody, MPDL3280A also made headlines during ASCO when results presented from a clinical trial showed the drug shrank tumors in 43 percent of patients involved in a phase I clinical trial. Data also showed that MPDL3280A shrank tumors in 13 out of 30 patients who had been previously treated for metastatic urothelial bladder cancer. Previously released data on this PD-L1 antibody showed promise in advanced melanoma, lung and kidney cancers; however, this was the first trial to test this form of immunotherapy against advanced bladder cancer. For more information, click here.
Advances in Cervical Cancer
- One particular study that has gained media attention was the first in which adoptive T-cell therapy showed response in women with advanced cervical cancer. Of the nine women treated, two saw their tumors completely disappear and they remian cancer-free more than one year later. One other participant saw partial tumor shrinkage and the others showed no response. For more information, click here.
Advances in Head and Neck Cancer and Melanoma
- Data presented involving anti-PD-1 treatment for patients with head and neck cancer followed suit with the early findings being presented on the anti-PD-1 antibody, Pembrolizumab (MK-3475), as a single agent in patients with PD-L1 positive advanced head and neck cancer. Data presented showed a best overall response rate of 20 percent in an early phase clinical trial. These are some of the first positive results for head and neck cancer patients in the past decade. For more information, click here.
- This same immunotherapy is currently being tested in two dozen different clinical trials in 30 different tumor types including melanoma, which was also highlighted at ASCO. One trial in particular involved a total of 411 patients with advanced melanoma, of which 211 had already received treatment with Ipilimumab but had stopped responding. Overall, 34 percent of patients experienced tumour response, as assessed by independent review, including 40 percent of patients not previously treated with ipilimumab and 28 percent of patients whose disease had progressed while on ipilimumab. Responses were durable with 88 percent ongoing at the time of analysis. For more information, click here.
- A follow-up study to melanoma data from last year’s meeting was also presented. The new data are showing longer-term results for the combination of Ipilimumab with Nivolumab for advanced disease. Clinical trial results showed that the combination of the two immunotherapies produced a median survival of 40 months for patients who also parciapted involved in the same study as last year. This is almost double the survival time of the results reported when the drugs were used alone rather than in combination. For more information, click here.
- Another follow-up study also showed promising results for patients with melanoma in the form of the first-ever, randomized phase III clinical trial of a new oncolytic virus in patients with cancer. The trial consisted of 436 patients with advanced melanoma who were treated with Talimogene Laherpaepvec (T-VEC), a genetically-modified form of the herpes simplex virus. Results released last year showed that T-VEC improved durable response rates, which included at least 50% tumor shrinkage in both injected and un-injected tumors lasting six months or longer. Of the patients who had an objective overall response, approximately 40% were complete responses, which included regression of both injected and un-injected lesions. Data showed a trend towards improved overall survival in patients treated with T-VEC, with a 21% reduction in the risk of dying, and patients treated with T-VEC had a 4.4 month improved survival compared to patients treated with recombinant GM-CSF. For more information, click here.
- Following up the 2011 approval of Ipilimumab as the first immune-checkpoint inhibitor in the treatment of inoperable stage IV metastatic melanoma, this year is data showing for the first time that this type immunotherapy at a higher dose is also effective in an adjuvant setting for earlier-stage disease. The final analysis of results from the study show that in patients with high-risk stage III disease, use of Ipilimumab after surgery reduces the relative risk for recurrence by about 25% as compared with placebo. For more information, click here.
Advances in Non-small Cell Lung Cancer (NSCLC)
- Early data regardining MK-3475 for the treatment of non-small cell lung cancer was also presented. The data showed that 45 patients treated had an objective response rate of 36 percent. Other studies are being conducted that use this immunotherpay in combination therapyas well. For more information, click here.
- MEDI4736 is yet another PD-L1 immunotherapy drug that gained a lot of attention at ASCO in several cancer types including NSCLC. Phase I clinical trial results were presented in which 27 patients with advanced solid tumors (including non-small cell lung cancer, melanoma and colorectal cancer) were treated with MEDI4736. Results showed 19 percent of patients experienced tumor shrinkage, and 39 percent saw their cancer stabilize after at least a year of treatment. For more information, click here.
- The treated patients with advanced NSCLC were separately reported in a poster discussion at ASCO as well. Data from approximately 150 NSCLC patients found no treatment discontinuations for toxicity, drug-related colitis of any grade, or grade three or four pulmonary toxicities. An early signal of clinical activity was observed in patients with both squamous and non-squamous NSCLC treated with MEDI4736. For more information, click here.
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