hello, i'm dr. jill o'donnell-tormey ceo and director of scientific affairs atthe cancer research institute. i'm here with three experts who are going to discuss with me important results coming out of the annualmeeting of the american society of clinical oncologyhere in chicago. thank you all for joining me today. and i'd like to start by throwing out a question for each of you
what would you say was the most important take home results for patients that you heard at asco this week? so i think one of the exciting developments this year is that we know that last year the big story was really the single agent activity of checkpoint inhibitors one of the more exciting new approaches to immunotherapy across a broad number of solid tumors.
and this year, the story is getting more nuanced. so we're still excited about the activity of these agents across a broad number of different tumor types but the story is getting more interesting. we're talking about combining these agents with other agents for better activity.
we're talking about predictive biomarkers that can help us identify who's going to respond. and i think just in general the story is getting richer and a lot more interesting and heading in a direction that will ultimatelybenefit a lot more patients. thanks very much, andy. leena, do you have anything to add to that?
well, i would agree with andy. i think that the story is still immunotherapy but it is more about combination immunotherapy and broadening the group forwhom immunotherapy might be helpful. i think what we've also learned is that there's a lot of differences in different cancers, that it's not a one size fits all story.
that there are different markers, there are different combinations that willbe useful in different settings. michel. well, jill immunotherapy is not monolithic. it comes in many flavors. and so this was a great meeting for what we call cars,
which are chimeric antigen receptors. several groups presented very exciting data showing that the science of car therapy is really moving forward. that's all good news for patients, for sure. leena, i know you're an expert in lung cancer and i think there was some very exciting data for different types of lung cancer that werereported. i think there were several exciting things
but specifically the same kind of combination therapy that's approved in melanoma a combination of a pd-1 inhibitor and a ctla-4inhibitor two different ways of activating t cells to attack tumor cells that same combination has now been tested in both non-small cell lung cancer and small cell lung cancer.
and we saw really promising results. the non-small cell lung cancer data is very, very preliminary. it was very small numbers of patients that were treated. but these were patients that were treatedbasically with a combination of nivolumab and ipilimumab instead of any chemotherapy. so patients who had never received any chemotherapy or any kind of standard therapy
were treated with these agents. and what we saw were response rates that rivaled those of chemotherapy, and in the subset of patients who had high pd-l1 expression which can be a predictive marker in non-small cell lung cancer, there were very, very high response rates. it was a very small subset,
but 12 out of 13 patients with major regressions of their cancers which is really exciting. and we hope that translates in a larger scale setting, in a randomized setting to something reallymeaningful. so small cell is actually, i think, the more exciting story because small cell lung cancer is a really very, very difficult cancer to treat
and it's a very, very aggressive cancer. and although patients get a few months of benefit from chemotherapy typically, most other therapies really haven't worked. so to see any activity which is exactly what we're seeing from both monotherapy pd-1 inhibitors as well this combination with ctla-4 inhibitors is really exciting. and that data was first presented last year.
the response rates in a larger subset this year were a little bit lower, but the overall group that was getting clinicalbenefit meaning not having their cancers grow was really striking. there were 43 percent of patients who werestill doing well after a year, which is almost unheard of for small cell lung cancer, so we hope that's really going to make a difference.
terrific. so andy, you're a specialist in head and neckcancer, a surgeon do you think checkpoint blockade is movingto become the new standard of care for head and neckcancers? one of the really exciting things that i saw was that we're seeing responses in very heavily pre-treated populations: patients who've had one, two, sometimes three rounds of prior therapy. this is a very hard population to treat
because their tumors have figured out how to evade almost everything. so the fact that we're seeing the responseswe are in these very difficult, refractory populations i think is quite exciting. michel, you already alluded to some ofthe cellular therapies is there more news in the blood cancers thatcame out? yes definitely. there were several updates at this asco meeting
on what we call cd-19 car therapy. this is a form of therapy that again, uses the patient's own cells, which are targeted to this molecule called cd-19. it's a target that's relevant to the majority of lymphomas and leukemias for which there is still today obviously a large unmet medical need.
and what we saw at this meeting are several groups, four big groups, presenting data no longer on 12 or 15 patients, but now in 50 patients, 60 patients sometimes more. confirming the earlier data and fine-tuning the delivery of this new medicine. there can be, on occasion, strong cytokine responses and
investigators are learning how to mitigate those effects without compromising any of the efficacy. another exciting news was that in adult acute lymphoblastic leukemia the data seems to suggest now that the car therapy could stand alone without requiring a follow up bone marrow transplant which was given hitherto to some of thosepatients.
so what we've really seen is consolidation of this approach. finetuning in the chemotherapy, the t cell dose, the way it is administered, and really the end of this opening cycle of phase i studies. what we look forward to seeing now are hopefully the first approvals of these therapies in the not too distantfuture. and the other big question now that's on everybody's
mind is: will this work for solid tumors? for some of your cancers. and we sure hope that it will and i think that's what we look forward tofor next year. i think there was also a report that not really treatment, but able to predictwho among colorectal cancers at different stages would be expected to have a better response, a better prognosis,
and this is something that's been called theimmunoscore. yes, and what's very exciting about that, and really groundbreaking, is that for so many years the focus and staging tumors has focused on the tumor itself, and of course its genetic alterations, which we all agree are very important. however, it is now emerging that
if you examine not just the tumor, but itssurroundings, which is made up of many cell types, mostlycells of the immune system good actors that could help reject the tumor, but bad actors that impede the immune response if you score this appropriately, it turns out that you can have very usefulinsights in the prognosis for these cancers. so really this reinforces on yet another level,
on the diagnostic level as well, the enormous importance of the immune response. i think that's exactly right. i think we're not just seeing treatment but showing proof that when a patient automatically has a strong immune response, an infiltration of t cells into their tumors, that they have a better chance of doing well.
so this is just additional information that tells us that immunotherapy is important and i think is here to stay in terms of the treatment of cancer. i'll ask any of you did you hear any negative news about immunotherapy that was reported here? it seemed to me that incremental positive responses was just adding to the wave of enthusiasm
that we are seeing across the world among oncologists and among patients. in the world of thoracic malignancies i feel like there were a couple presentations about two different immunotherapies in mesothelioma that i think were not the hoped-for results. we knew that mesothelioma patients express high levels of pd-l1 and we had thought that this would be a very
good therapy for them, and in fact last year there was data presented about pembrolizumab that suggested high chancesof benefit. we didn't see that with some different drugsthis year but i think, again, it underscores the fact that we need to look for the right patients and for the right patients there can be really durable and strong benefits and we need to have better ways of identifying people upfront. any closing remarks?
anything else that i've missed that you thinkis important that patients need to hear about? yes, immunotherapy as the big wave continues to unfold and gather strength. the combinations now will provide a vast rangeof exciting trials that we'll hope to see. cell therapies are establishing themselves as something that's here to stay and it'sa younger field that's yet to be developed.
and many of us believe that the vaccines that were so preeminent 20 years ago and that faded out a little bit are likely to make a comeback as well as an adjunct to either the cell therapy andof course to the checkpoint blockade. very well said. well, thank you all for takingthe time to discuss this with me i hope you found today's discussion helpfuland informative. if you'd like to stay up to date on othernews about immunotherapy please visit the cancer research institute's website
at cancerresearch.org thank you very much for watching.
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