3 Questions on…

Answers straight from the experts on the latest news and topics in oncology

Friday, May 23, 2014

3 Questions on… ASCO14 Immunotherapy Highlights

With JEFFREY S. WEBER, MD, PHD, of Moffitt Cancer Center



Immunotherapy — particularly for the treatment of melanoma — played a break-out role at last year’s American Society of Clinical Oncology Annual Meeting with pivotal findings for the anti-PD-L1 antibody MPDL3280A and for the ipilimumab-nivolumab combination regimen being reported. Current ASCO President Clifford A. Hudis, MD, deemed it “the beginning of an exciting new chapter of cancer” (OT 6/25/13 issue).


Will the trend continue at this year’s 2014 Annual Meeting?


Yes, said Jeffrey S. Weber, MD, PhD, Director of the Donald A. Adam Comprehensive Melanoma Research Center at Moffitt Cancer Center — who will be moderating the Oral Abstract Session at ASCO this year on Melanoma and Skin Cancers (Mon., 6/2, 3-6 pm). “But it’s going to have to meet a pretty high bar.”


In an interview, Weber previews what to expect — and what not to miss…


1. Last year was a break-out year for immunotherapy — how will this year top it?


“Last year we saw significant clinical impact with high response rates, long duration of responses, and intimation that you had clearly prolonged survival in patients [with melanoma] who had failed on all other therapies, but then got PD-1 blockade. Everyone realized that these drugs were going to get approved — and it was obvious that they were going to provide significant patient benefit. And it was not just one drug, but three different drugs. Everyone felt the PD-1 blockade had arrived.


“This year, for the first time, we’re going beyond melanoma. You’re going to see some of this in solid tumors. There’s going to be data on the PD-1 antibody in lung cancer. There are studies on tumor infiltrating lymphocytes in cervical cancer and adoptive therapy.”


2. What would you say was the impetus to move immunotherapy beyond melanoma?


“Melanoma is the immunogenic tumor — if an immunotherapy is going to work, you’re going to have to test it in melanoma. But, people realized that when they started to reach across a broad range of cancers in the first Phase I trial of nivolumab, it looked like there was some activity in lung cancer and maybe colon cancer — that was the impetus, and it was a good thing.


“I call it the Rodney Dangerfield effect. His punch line was: ‘I don’t get no respect.’ With immunotherapy, for years people thought it would only work in melanoma, the immunogenic tumor. Now it works really well in melanoma with long survival, and now it’s starting to work in renal cell cancer, non-small cell lung cancer, and maybe other cancers. Now there’s some respect in the field. It’s all about the non-melanoma data.”


3. What about in melanoma — what’s going to be the big immunotherapy news this year?


“You’re going to see expanded data on what came out last year — follow up data and long-term survival data. Antoni Ribas, MD, PhD, will be talking about MK-3475. Michael Atkins, MD, will be talking about pidilizumab, another PD-1 antibody. Stephen Hodi, MD, will be talking about long-term survival for nivolumab. And, Mario Sznol, MD, will be talking about ipilimumab with nivolumab.


“Then you’ll have Howard Kaufman, MD, talking about T-VEC [talimogene laherparepvec], and Alexander Eggermont, MD, PhD, presenting the final definitive Phase III relapse-free survival data from the ipilimumab versus placebo EORTC 18071 trial (the CTL4 antibody).


“Those are all pretty serious.”