First-Line Keytruda Plus Chemotherapy Improves OS, PFS in Non-Small Cell Lung Cancer

Excerpt:

“The addition of pembrolizumab to pemetrexed and cisplatin or carboplatin improved OS and PFS as first-line treatment for patients with metastatic nonsquamous non-small cell lung cancer, according to a manufacturer-issued press release.

“Pembrolizumab (Keytruda, Merck) — an anti-PD-1 therapy — is indicated for the treatment of patients with unresectable or metastatic melanoma, in addition to the treatment of other cancer types.”

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Immunotherapy Continues Growth With Trials in mCRPC

Excerpt:

“Although modern immunotherapy has yet to have a breakthrough in prostate cancer to the degree it has had in lung cancer or urothelial carcinoma, combinations with anti–PD-1/PD-L1 agents are beginning to show promise for these patients in clinical trials.

“Currently ongoing is a phase II trial of durvalumab (Imfinzi) in combination with the PARP inhibitor olaparib (Lynparza) in patients with metastatic castration-resistant prostate cancer (mCRPC; NCT02484404). Investigators note that previous data have suggested that 25% to 30% of sporadic mCRPC has DNA-repair pathway defects. Results thus far have demonstrated that the synergy of durvalumab and olaparib proves that the combination may be a viable option for patients with mCRPC who are heavily pretreated. The trial is still accruing.”

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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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Inovio Pharmaceuticals Initiates Immuno-Oncology Clinical Study for Glioblastoma in Combination with Regeneron’s PD-1 Inhibitor

Excerpt:

“Inovio Pharmaceuticals, Inc. (NASDAQ:INO) today initiated a phase 1b/2a immuno-oncology trial in patients with newly diagnosed glioblastoma (GBM) designed to evaluate cemiplimab (also known as REGN2810), a PD-1 inhibitor developed by Regeneron Pharmaceuticals, Inc.(NASDAQ:REGN), in combination with Inovio’s INO-5401 T cell activating immunotherapy encoding multiple antigens and INO-9012, an immune activator encoding IL-12.”

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Immune-Related Adverse Events Predict Efficacy of Nivolumab in NSCLC

Excerpt:

“While immunotherapy with programmed death receptor 1 (PD-1) inhibiting antibodies has revolutionized the treatment of non-small cell lung cancer (NSCLC), use of these agents comes at the cost of potential serious immune-related adverse events (irAEs). In melanoma, development of cutaneous irAEs, such as rash and vitiligo, during treatment with PD-1 inhibitors has been shown to be associated with survival benefit, suggesting that early onset of irAEs may predict treatment outcomes. However, in NSCLC, the predictive value of immunotherapy-related toxicity as a clinical marker for efficacy to PD-1 inhibition is unknown.  A multi-institution retrospective study investigated the relation between the development of irAEs and efficacy of PD-1 inhibitors in 134 patients with advanced or recurrent NSCLC who received second-line treatment with nivolumab. The primary outcome for this analysis was progression-free survival (PFS) according to the development of irAEs in a 6-week landmark analysis.”

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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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Merck’s KEYTRUDA® (pembrolizumab) More Than Doubled Median Overall Survival Compared to Chemotherapy After Two Years of Follow Up in First-Line Treatment of Patients with Metastatic Non-Small Cell Lung Cancer with High Levels of PD-L1

Excerpt:

“Merck (NYSE: MRK), known as MSD outside the United States and Canada, today announced the presentation of updated overall survival (OS) findings, a secondary endpoint, from the phase 3 KEYNOTE-024 trial evaluating KEYTRUDA®(pembrolizumab), the company’s anti-PD-1 therapy, as a first-line monotherapy in patients with non-small cell lung cancer (NSCLC) whose tumors express high levels of PD-L1 (tumor proportion score [TPS] of 50 percent or more). The study included patients with squamous and nonsquamous NSCLC with no EGFR or ALK genomic tumor aberrations. Findings – which are based on more than two years of follow-up – will be presented in an oral presentation at the 18th World Conference on Lung Cancer (WCLC) hosted by the International Association for the Study of Lung Cancer in Yokohama, Japan (Abstract OA 17.06).”

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Addition of Stereotactic Ablative Radiotherapy to Nivolumab Improves Lung Cancer Survival

Excerpt:

“The combination of stereotactic ablative radiotherapy plus anti-PD-1 therapy improved survival among patients with advanced lung cancer, according to a retrospective analysis presented at the International Association for the Study of Lung Cancer Multidisciplinary Symposium in Thoracic Oncology.

“Immune checkpoint inhibitors have improved outcomes in non-small cell lung cancer. However, the absolute improvement over docetaxel is only 3 to 5 months for median OS and 15% to 20% for overall response rate.”

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