Neoadjuvant Dabrafenib/Trametinib Leads to High pCR Rates in Bulky Resectable Melanoma, But Recurrences Are Common

Excerpt:

“Phase II results demonstrated that nearly half of patients with resectable stage IIIB/C BRAF V600-mutant melanoma achieved pathologic complete response (pCR) with neoadjuvant combination therapy consisting of dabrafenib (Tafinlar) and trametinib (Mekinist). Additionally, no patients experienced disease progression during the neoadjuvant treatment, said Alexander M. Menzies, MD, who presented the data at the 2017 ESMO Congress in Madrid.

” ‘Nearly 50% of our patients had a complete eradication of their melanoma at the time of surgery. Fifty percent had some remaining melanoma in the surgical specimen, but every patient had some degree of tumor shrinkage on therapy,’ said Menzies, a medical oncologist and senior research fellow at Melanoma Institute Australia in Sydney, Australia. ‘These are patients who otherwise would just have surgery and then have observation. And, these are patients who are at very high risk, probably the highest risk of recurrence without further therapy.’ ”

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Array BioPharma Announces FDA Acceptance For Review Of Binimetinib And Encorafenib New Drug Applications For Patients With Advanced BRAF-mutant Melanoma

Excerpt:

“Array BioPharma (ARRY) today announced that the U.S. Food and Drug Administration (FDA) has accepted for review its New Drug Applications (NDAs) to support use of the combination of binimetinib 45 mg twice daily and encorafenib 450 mg once daily (COMBO450) for the treatment of patients with BRAF-mutant advanced, unresectable or metastatic melanoma. The FDA set a target action date under the Prescription Drug User Fee Act (PDUFA) of June 30, 2018 for both applications. In addition, the FDA informed Array that based on their preliminary review of the applications they have not identified any potential review issues, and that they are not currently planning to hold an advisory committee meeting to discuss these NDAs.  Array completed its NDA submissions at the end of June 2017based on findings from the pivotal Phase 3 COLUMBUS trial.”

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Benefits Vary With Docetaxel and Abiraterone in High-Risk Prostate Cancer

Excerpt:

“The first head-to-head comparison of docetaxel and abiraterone acetate for high-risk prostate cancer patients starting long-term hormone therapy found benefit with both treatments when added to androgen deprivation therapy (ADT). Treatment decisions may come down to specific toxicities, which differ between the treatments.

“The large STAMPEDE trial previously found that both docetaxel and abiraterone improved outcomes when compared with placebo. “Right now, oncologists and urologists want to know which combination is preferable, which is why we conducted this analysis,” said study author Matthew Sydes, MSc, a statistician at University College London.”

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Priming Immune System Before Nivolumab Improves Response in Metastatic TNBC

Excerpt:

“In patients with metastatic triple negative breast cancer (TNBC), turning a nonimmunogenic (“cold”) tumor into an immunogenic (“hot”) tumor appears to be feasible, thereby improving sensitivity to immune therapy with nivolumab (Opdivo).

“In a phase II study of 50 patients with metastatic TNBC who received palliative chemotherapy, priming the immune system with low-dose chemotherapy for 2 weeks or radiation therapy before starting nivolumab resulted in a best objective response rate (ORR) of 24%, announced Marleen Kok, MD, at the 2017 ESMO Congress in Madrid.”

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ESMO: Lilly Breast Cancer Drug Keeps Pace With Pfizer, Novartis Rivals

Excerpt:

“Eli Lilly and Co.’s experimental breast cancer drug abemaciclib significantly cut the risk of disease progression in a late-stage trial, bolstering the drug’s potential to become a new source of growth for the Indianapolis pharma’s oncology business.

“Updated results from a late-stage study known as MONARCH 3, presented over the weekend at the European Society of Medical Oncology’s annual meeting, showed abemaciclib in combination with an aromatase inhibitor extended progression-free survival in previously untreated patients with metastatic breast cancer.

“Eli Lilly has previously said abemaciclib could be best in class, yet it’s not clear whether the data disclosed to date will be enough to outshine rival drugs already marketed by Pfizer Inc. and Novartis AG.”

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Osimertinib Improves Progression-Free Survival in Patients With EGFR Mutated Lung Cancer

Excerpt:

“Osimertinib improves progression-free survival by 54% compared to standard first line therapy in patients with EGFR mutated non-small-cell lung cancer (NSCLC), according to late-breaking results from the FLAURA trial presented today at the ESMO 2017 Congress in Madrid.

“EGFR  are present in around 15% of NSCLC in Western populations, rising to 35% in Asian populations. EGFR inhibitors are superior to chemotherapy in the first line treatment of these patients. However, despite high response rates and good progression-free survival, patients invariably develop  to drugs such as erlotinib and gefitinib. In the majority of patients this resistance is mediated by a T790M mutation.”

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ESMO 2017 Press Release: Combination Immunotherapy in Second/third Line Extends Mesothelioma Survival to 15 Months

Excerpt:

“Combination immunotherapy as second or third line treatment extends overall survival to at least 15 months in patients with pleural malignant mesothelioma, according to late-breaking results from the MAPS2 trial presented today at the ESMO 2017 Congress in Madrid.

“Malignant pleural mesothelioma (MPM) is a rare disease usually caused by occupational exposure to asbestos. First line therapy is pemetrexed and platinum chemotherapy, with or without bevacizumab. There is no approved second line treatment and drugs that have been tested in this setting had low efficacy, with a disease control rate under 30%. Phase II studies have shown promising activity of checkpoint inhibitors as second line treatment.”

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AstraZeneca Immunotherapy Study Shows Benefit for Niche Group of Lung Cancer Patients

Excerpt:

The jackpot cancer immunotherapy ambitions of AstraZeneca stumbled in July with the failure of a closely watched clinical trial in newly diagnosed lung cancer. Friday, the Anglo-Swedish drugmaker attempts a recovery with positive results from a new study, also in lung cancer, but aimed at a niche group of patients.

“AstraZeneca still trails cancer immunotherapy leaders Merck and Bristol-Myers Squibb, but staking a claim in lung cancer marks progress.”

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PD-1/IDO Combination Active in Advanced Melanoma

Excerpt:

“A majority of patients with advanced melanoma responded to the combination of pembrolizumab (Keytruda) and the investigational IDO1 inhibitor epacadostat, as reported at the European Society of Medical Oncology congress in Madrid.

“In phase I/II results from the ECHO-202/KEYNOTE-037 trial, the combination induced objective responses in 29 of 53 (55%) efficacy-evaluable untreated patients, including seven complete responses. Twenty-two of 38 evaluable patients (58%) responded to the recommended phase II dose of epacadostat (100 mg).”

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