Does Gut Flora Impact the Response to Cancer Immunotherapy?

Excerpt:

“Gut microbes can help or hinder cancer patients’ response to immunotherapy, two new studies suggested.

“In 112 melanoma patients undergoing anti-PD-1 immunotherapy, those with a high diversity of gut microbes had not yet reached median progression-free survival (PFS) after nearly 2 years, because less than half of them had progressed, while median PFS in the low-diversity group was 188 days (hazard ratio 3.57, 95% CI 1.02-12.52, P<0.05), said Jennifer Wargo, MD, of the MD Anderson Cancer Center in Houston, and colleagues.”

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T-VEC, Ipilimumab Regimen Improves Survival in Advanced Melanoma

Excerpt:

“The combination of an oncolytic virus plus a checkpoint inhibitor improved survival among patients with advanced melanoma compared with monotherapy, according to data from a phase 2 study published in Journal of Clinical Oncology.

“Novel monotherapies, such as ipilimumab (Yervoy, Bristol-Myers Squibb) — a CTLA-4 antibody — have ‘transformed patient care in advanced melanoma,’ the researchers wrote.”

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Glembatumumab Vedotin Induces 61% DCR in Uveal Melanoma

Excerpt:

“Glembatumumab vedotin (CDX-011) induced a disease control rate (DCR) of 61% in patients with metastatic uveal melanoma, despite a low a low objective response rate (ORR) of 6%, according to results from the the phase II NCI9855 study.

“There were no complete responses, 2 (6%) partial responses, and 17 patients (55%) with stable disease. Twelve patients (39%) experienced disease progression.”

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IL-12 Therapy Elicits Encouraging Response Rates in Melanoma

Excerpt:

“Immunopulse IL-12 monotherapy and in combination with pembrolizumab was associated with encouraging response rates and safety data in patients with melanoma who may not respond to anti-PD-1 therapy, according to a press release.

“The findings were presented at the 9th World Congress of Melanoma — A Joint Meeting with the Society for Melanoma Research. The data include a phase 2 Immunopulse IL-12 (OncoSec) monotherapy study with 51 patients and a phase 2 study of the immunotherapy in combination with pembrolizumab, which included 22 patients.”

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Novel Combinations Mark Next Step for Melanoma

Excerpt:

“Immunotherapy has led a transformation for melanoma care but combinations of anti–PD-1 and CTLA-4 agents are toxic and biomarkers are not available to help personalized treatment, calling for further research into less toxic and more effective options, according to a presentation by Caroline Robert, MD, PhD, at the 2017 World Congress of Melanoma.

“At this point, the only approved immunotherapy combination remains the PD-1 inhibitor nivolumab (Opdivo) and the CTLA-4 inhibitor ipilimumab (Yervoy). However, research into combination approaches is now focusing on triplets of anti–PD-1 therapies and new checkpoints, such as IDO. Additionally, ongoing research continues to search of a biomarker of response for immunotherapy in melanoma.”

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Immune-Stimulator Boosts Pembrolizumab in Melanoma Patients With “Cold” Tumors

Excerpt:

“Adding the immune stimulator ImmunoPulse IL-12 to pembrolizumab (Keytruda) produced promising activity among patients with melanoma identified as unlikely responders to anti–PD-1 therapies.

“Data from the phase II OMS-I102 trial presented at the 2017 World Congress of Melanoma showed that the combination induced an overall response rate (ORR) of 50% (n = 11) among 22 patients with baseline biomarker data suggesting they would not respond to anti–PD-1 therapy.”

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Overall Survival up for Melanoma Brain Metastases

Excerpt:

“Overall survival (OS) for patients with melanoma brain metastases (MBM) has improved significantly since 2000, according to a study published online Oct. 12 in Cancer.

“Sarah Sloot, M.D., from Groningen University Medical Center in the Netherlands, and colleagues identified 610 patients with unresectable American Joint Committee on Cancer stage III/IV melanoma who received first-line systemic therapy at Moffitt Cancer Center between 2000 and 2012.”

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FDA Grants Priority Review to Opdivo for Resected, High-Risk Melanoma

Excerpt:

“The FDA granted priority review to nivolumab for the treatment of patients with melanoma who are at high risk for disease recurrence following complete surgical resection, according to the drug’s manufacturer.

“Nivolumab (Opdivo, Bristol-Myers Squibb), a PD-1 checkpoint inhibitor, previously received breakthrough therapy designation for this indication.”

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Adjuvant Ipilimumab in Melanoma: Future in Doubt

Excerpt:

“The future of adjuvant ipilimumab (Yervoy, Bristol-Myers Squibb) for the treatment of resected stage III melanoma could be in doubt, as a combination of ‘astronomically high’ costs and better outcome data with another treatment threaten its position as the standard of care, argues an expert.

“Ipilimumab, a monoclonal antibody that blocks CTLA-4, was shown to significantly improve recurrence-free and overall survival vs placebo when used after surgery. These data, from the EORTC 18071 trial, led to its approval by the US Food and Drug Administration (FDA) as an adjuvant therapy for patients with stage III melanoma in October 2015. This extended its original approval in 2011 to treat late-stage melanoma in patients who are not candidates for surgery.”

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