Articles related to IMMUNOTHERAPY

In a randomized clinical trial of 128 patients with refractory mCRC, the addition of the PD-L1 inhibitor atezolizumab to capecitabine and bevacizumab therapy resulted in marginally longer PFS vs the placebo comparator arm. However, the median improvement — 4.4 vs 3.6 months – was deemed not clinically relevant.

This update on the PACIFIC trial comparing durvalumab with placebo in patients with unresectable, stage III non–small-cell lung cancer demonstrated robust and sustained OS and durable PFS benefit. The updated, exploratory analyses of survival, approximately 5 years after the last patient was randomly assigned demonstrate robust and sustained OS and durable PFS benefit with durvalumab after chemoradiotherapy. An estimated 42.9% of patients randomly assigned to durvalumab remain alive at 5 years and 33.1% of patients randomly assigned to durvalumab remain alive and free of disease progression. These results establish a new benchmark for standard of care in this setting.

Interest in immune-modulating neoadjuvant therapy for melanoma is growing. It is possible that BRAF/MEK inhibition will be more effective in the neoadjuvant than in the adjuvant setting because of the effect of the tumor biomass. And the benefits neoadjuvant therapy would offer in assessing biologic response assessment to treatment are significant. In this review the authors discuss the rationale for this treatment approach, summarize completed and ongoing neoadjuvant clinical trials, and contextualize these findings within the growing body of knowledge about targeted and immune checkpoint therapy.

Jacob Laubach, MD, at the Dana-Farber Cancer Institute provides a summary of the most recent update from the GRIFFIN trial, assessing daratumumab plus lenalidomide, bortezomib, and dexamethasone in newly diagnosed multiple myeloma patients. After 24 months of maintenance therapy or treatment discontinuation (median follow-up of 38.6 months), the rate of stringent complete response (sCR) was 66% in the D-RVd treatment arm versus 47.4% in the RVd treatment arm. At the time of data collection, median PFS had not been reached in either arm but is trending towards favoring D-RVd versus RVd. The estimated 36-month PFS rate was 88.9% for D-RVd and 81.2% for RVd.

A systematic review identified 204 eligible publications from 2000 through 2017, with much of the evidence consisting of systematic reviews of observational data, consensus guidelines, case series, and case reports. Due to the paucity of high-quality evidence on management of immune-related adverse events, recommendations are based on expert consensus.

From JAMA Network Open comes this conclusion: “In this study, the benefit associated with olaparib was reduced, eliminated, or inferior in specific subgroups of patients when treatment outcomes were compared with a more active standard of care, ie, cabazitaxel. While treatment with olaparib was associated with superior rPFS in patients with BRCA1/2 variants, those with other HRR variants may have worse outcomes with this approach, which should be reassessed by national guidelines. Numerous active studies…will add to the data regarding the role of PARP inhibitors in mCRPC.”