NKTR-214/Nivolumab Combination Shows Promise in Early Study

Excerpt:

“The combination of the CD122-biased cytokine NKTR-214 and the PD-1 inhibitor nivolumab (Opdivo) demonstrated target lesion reductions of 72% for patients with advanced cancers, according to findings from the phase Ib PIVOT-02 trial presented at the 2017 SITC Annual Meeting.

“The dose escalation trial enrolled patients in the first- or second-line setting with advanced non–small cell lung cancer (NSCLC), renal cell carcinoma (RCC), and melanoma. The objective response rates (ORR) by RECIST criteria ranged from 46% to 75% across tumor types. Additionally, the combination was tolerable, with no discontinuations attributed to adverse events (AEs).”

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Benefit of End-Stage Chemotherapy Is Questioned

“It is an excruciating question for cancer patients with a prognosis of only months to live. Should they try another round of chemotherapy?

“Guidelines for oncologists say no for very sick patients, those who are often bedridden and cannot handle most daily needs themselves. But for patients who are more self-sufficient, chemotherapy is considered a reasonable option. Despite its well-known toxic side effects, many end-stage patients and their doctors have considered chemotherapy worth trying, believing it may ease discomfort or buy time.

“Now, a study suggests that even those stronger patients may not benefit from end-of-life chemotherapy — and that for many their quality of life may worsen in their final weeks compared with patients who forego last-ditch treatment.

“ ‘It worsened quality of life for those that are relatively healthy, and those are the ones that the guidelines support treating,’ said Dr. Charles Blanke, a medical oncologist at Oregon Health and Science University, who was not involved in the study. ‘Chemotherapy is supposed to either help people live better or help them live longer, and this study showed that chemotherapy did neither.’ “


Adding Atezolizumab to Chemotherapy Shows Promise in NSCLC

“The anti–PD-L1 agent atezolizumab (MPDL3280A) was recently investigated for safety and efficacy in combination with platinum-based doublet chemotherapy in treatment-naïve patients with advanced non–small cell lung cancer (NSCLC). Results from the phase Ib study were presented at the 2015 ASCO Annual Meeting.

“The multiple-arm study looked at MPDL3280A with a different chemotherapy backbone in each arm: carboplatin plus paclitaxel (Arm C; n = 8) carboplatin plus pemetrexed (Arm D; n = 14) or carboplatin plus nab-paclitaxel (Arm E; n = 15).

“Across all arms, the overall response rate (ORR) was 67% (48%-82%), with 60% ORR (19%-92%) in Arm C (3 partial responses [PRs]), 75% (45%-93%) in Arm D (9 PRs), and 62% (33%-83%) in Arm E (6 PRs, 2 complete responses).

“Regarding the safety profile, the researchers concluded that the combination regimens were well tolerated. The most frequent all-grade adverse events included those commonly associated with chemotherapy, such as nausea (Arms C and D, 50%; Arm E, 73%), fatigue (Arm C, 38%; Arm D, 36%; Arm E, 73%) and constipation (Arm C, 25%; Arm D, 71%; Arm E, 27%).

“OncLive spoke with Stephen Liu, MD, lead author on the study and assistant professor, Division of Hematology and Oncology, Georgetown University, to better understand the results and purpose of the uniquely designed trial, and how oncologists may need to rethink trial design when investigating similar novel agents.”


New Type of Clinical Trial Launching for Advanced Melanoma

“Mayo Clinic and the Translational Genomics Research Institute (TGen) are helping launch a national clinical trial that will apply the latest in precision medicine to treat advanced melanoma skin cancer.

“The study leverages advances in genomics, informatics, and health information technology, yielding more precise medical treatments for patients with this devastating disease.

“Mayo Clinic is the only clinical site in Arizona to offer this new treatment, sponsored by Stand Up to Cancer (SU2C) and the Melanoma Research Alliance. These clinical trials are the culmination of nearly four years of research under an SU2C Melanoma Dream Team grant.

“Metastatic melanoma is a type of cancer that has spread from the skin to other parts of the body, most frequently the lungs, muscles, brain, and liver. Metastatic melanoma is responsible for more than 9,000 deaths a year in the United States, so there remains an urgent need for new treatment options.”


Important New Research on Early Palliative Care for Advanced Cancer Patients Published

“Researchers at Trinity College Dublin and Mount Sinai in New York have just published new research which for the first time provides strong evidence on the economic benefits of early palliative care intervention for people with an advanced cancer diagnosis. Their findings were published today in the highly esteemed international peer reviewed Journal of Clinical Oncology.

“Previous research has shown the clinical benefits of early palliative care, but this new study robustly demonstrated how early access to expert palliative care decision making resulted in very significant cost reductions of up to 24%. The intervention reduced both the length and intensity of hospital stay for patients with advanced cancer.

“The researchers from Trinity’s Centre for Health Policy and Management and Mount Sinai’s Icahn School of Medicine, led by Peter May, HRB Economics of Cancer Fellow at Trinity, studied over 1000 patients’ pathways of care in five major US hospitals and looked at costs associated with their care based on whether they saw a specialist palliative care consultation team or received standard hospital care.”


ASCO Launches First-ever Clinical Trial: Aims to Learn from Patients with Advanced Cancer Who Lack Standard Treatment Options

“The American Society of Clinical Oncology (ASCO) today announced its first-ever clinical trial that will offer patients with advanced cancer access to molecularly-targeted cancer drugs and collect ‘real-world’ data on clinical outcomes to help learn the best uses of these drugs outside of indications approved by the Food and Drug Administration (FDA). Plans for the Targeted Agent and Profiling Utilization Registry (TAPUR) study, including the participation of major pharmaceutical companies that will contribute free drugs, were released in a news briefing at the Society’s 2015 Annual Meeting in Chicago.

“The ASCO-sponsored prospective, non-randomized clinical trial will collect information on the anti-tumor activity and toxicity of commercially available, targeted cancer drugs in a range of cancer types, including any advanced solid tumor, multiple myeloma, or non-Hodgkin lymphoma with a genomic variation known to be a drug target.

“ ‘Oncologists often use therapies approved for a specific cancer indication to treat people with other types of advanced cancer, but we very rarely learn from that experience to benefit other patients,’ said ASCO President Peter Paul Yu, MD, FACP, FASCO. ‘TAPUR will document the real-world experience of patients who receive commercially available targeted anti-cancer drugs and will describe the effectiveness and side effects of a range of targeted agents available in this study.’ “


A Quarter of Lung Cancer Patients Receive EGFR Inhibitors Before Knowing the Results of Testing for Mutations in EGFR

“Almost one in four patients (24%) with advanced lung cancer in Europe, Asia and the US are not receiving EGFR test results before being started on treatment, researchers report at the European Lung Cancer Conference.

“Medical Oncologist James Spicer from King’s College London at Guy’s Hospital, London, and colleagues studied how widely hospitals had implemented testing for mutations in the epidermal growth factor receptor gene among lung cancer patients.

“Targeted therapies can more effectively treat cancers that are known to carry such mutations, Dr Spicer said. However anecdotal evidence had suggested the tests required to clarify a patient’s status were not always been conducted, Dr Spicer said.

” ‘The arrival of a new group of targeted EGFR inhibitors for the treatment of lung cancer driven by mutations in the EGFR gene has brought with it a new requirement for diagnostic laboratories to implement genetic testing,’ he explained. ‘For many institutions this has represented a significant departure from traditional pathology, which had previously focused only on microscopic examinations of tumour tissue.’ “


Personalized Vaccines May Hold Promise for Melanoma Treatment

“Personalized melanoma vaccines can be used to marshal a powerful immune response against unique mutations in patients’ tumors, according to early data in a first-in-people clinical trial at Washington University School of Medicine in St. Louis.

“The tailor-made vaccines, given to three with advanced melanoma, appeared to increase the number and diversity of -fighting T responding to the tumors. The finding is a boost to cancer immunotherapy, a treatment strategy that unleashes the immune system to seek out and destroy cancer.

“The research is reported April 2 in Science Express, in a special issue devoted to cancer immunology and immunotherapy.”


Dermatologists Address BRAF, MEK Inhibitors and Other Treatments for Advanced Melanoma

“Rhoda M. Alani, MD, FAAD, and Debjani Sahni, MD, discussed current and future targeted therapy and immunotherapy for patients with advanced melanoma at the American Academy of Dermatology Annual Meeting, here.

“ ‘Four years ago, we had nothing to improve advanced melanoma patients’ survival, and now we have several new therapies available, with several others in the pipeline,’ Sahni, an assistant professor of dermatology and director of the cutaneous oncology program at Boston University School of Medicine, said in a press release from the American Academy of Dermatology (AAD). ‘Although these developments are promising for patients, we don’t have all the answers yet. There’s a lot more research that needs to be done.’ ”