IMMUNOTHERAPY

Benjamin P. Levy, MD, clinical director of Medical Oncology at John Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, discusses the unique adverse events with immunotherapy agents and how physicians can work together to overcome these challenges.

Checkpoint inhibitors are revolutionizing the treatment of patients with both squamous and nonsquamous non-small cell lung cancer, and are quickly assuming a predominant role, especially in the frontline setting, due to recent exciting results from large trials.<br /> &nbsp;

The use of checkpoint inhibition in patients with locally advanced non&ndash;small cell lung cancer in combination with chemoradiation, and specifically durvalumab from the PACIFIC trial, has shown the first significant survival benefits in almost 25 years, according to Corey J. Langer, MD.

Combinations with immunotherapy agents have surged ahead with new regimens showing great potential for the treatment of patients with lung cancer, Corey Langer, MD, said during a presentation at the&nbsp;<em>19th Annual </em>International Lung Cancer Congress (ILCC). Knowledge about a growing number of biomarkers are helping to guide treatment decisions with these combination options, he said, but the one standard of care has not yet been determined.

Several biomarkers are beginning to emerge for immunotherapy in non&ndash;small cell lung cancer, and the collection of these markers, when used together, could further help to predict which patients are likely to respond to these therapies alone or in combination, according to a presentation by Giorgio Scagliotti, MD, PhD, at the <em>19th Annual</em> International Lung Cancer Congress.

David G. Maloney, MD, PhD, medical director of immunotherapy at the Seattle Cancer Care Alliance and member of Fred Hutchinson Research Center, discusses the clinical trials that are currently investigating chimeric antigen receptor T cells at the Bezos Family Immunotherapy Clinic at Fred Hutchinson.

A novel immunotherapy agent has demonstrated significant survival rates for patients with metastatic uveal melanoma, according to updated results released at the 2018 ASCO Annual Meeting.

Immune checkpoint inhibitors, alone or in combination, are associated with increased incidence of some cardiovascular toxicities in patients with cancer, according to results from a cross-trial pooled analysis presented in a poster at the 2018 ASCO Annual Meeting.

In patients with metastatic or unresectable locally advanced triple-negative breast cancer, frontline treatment with&nbsp;atezolizumab (Tecentriq) plus nab-paclitaxel (Abraxane)&nbsp;significantly reduced the risk of disease progression or death compared with nab-paclitaxel, according to topline results from the phase III IMpassion130 study.&nbsp;

Immunotherapy may provide an opportunity to change the treatment paradigm of small cell lung cancer as new clinical trials report out in the next year, says&nbsp;Anne Chiang, MD, PhD.&nbsp;Recent results with immunotherapy agents in the second-line setting have already influenced guidelines.

A&nbsp;supplemental biologics license application has been accepted by the FDA seeking approval for&nbsp;the combination of nivolumab plus ipilimumab for the frontline treatment of patients with advanced non&ndash;small cell lung cancer with tumor mutational burden&nbsp; &ge;10 mutations per megabase, according to Bristol-Myers Squibb, the manufacturer of both immune checkpoint inhibitors.

Charles G. Drake, MD, PhD, director of Genitourinary Oncology at New York Presbyterian/Columbia University Medical Center, discusses his thoughts on whether sunitinib would be more successful as a treatment for patients with renal cell carcinoma if used in the neoadjuvant setting.

Maria Svensson, MD, Lund University, discusses the growing interest in checkpoint inhibitor blockade treatments for gastrointestinal cancers. In the past, there have been promising results with this treatment in metastatic disease.

Alexander M. Eggermont, MD, PhD, director general of Gustave Roussy Cancer Campus Grand Paris in Villejuif, France, discusses the history of immune checkpoint inhibitors in the treatment landscape of melanoma.

Researchers&rsquo; understanding of why patients with cancer do or do not respond to treatment with immune checkpoint inhibition is constantly evolving, with new developments in innate and adaptive immunity, the tumor microenvironment, and more changing the way that immunotherapy is viewed and used. Many researchers are now pointing to the effect that gut microbiota have on patients&rsquo;&nbsp;response to checkpoint inhibitors and its implications for the treatment of patients receiving immunotherapy.

On May 18, 2018, the FDA released a safety alert concerning decreased survival observed in 2 separate ongoing first-line randomized clinical trials of checkpoint inhibitors in metastatic urothelial cancer for patients treated in the monotherapy arms with low PD-L1 expression compared with patients who received cisplatin- or carboplatin-based chemotherapy.

According to updated data from the phase I/II PIVOT-02 trial presented at the 2018 ASCO Annual Meeting, the combination of NKTR-214 plus the PD-1 inhibitor nivolumab demonstrated promising antitumor activity in patients with advanced solid tumors, particularly in PD-L1&ndash;negative patients.

Following a planned interim analysis, 2 early-phase clinical trials&nbsp;exploring daratumumab in combination with either a PD-1 inhibitor for multiple myeloma or a PD-L1 inhibitor for non&ndash;small cell lung cancer have been terminated, according to a statement from Genmab, the company codeveloping daratumumab with Janssen.

Editori-in-Chief of <em>Targeted Therapies in Oncology </em>discusses the importance of KEYNOTE-189 which investigated whether the best frontline treatment for any patient is chemotherapy, immunotherapy, or a combination of the 2. Data from the IMpower150 and CheckMate 227 also investigate this question in various patient populations.

Amanda Ramos, MD, a first-year fellow at the Massachusetts General Hospital in Boston, discusses the future potential of checkpoint inhibition therapy in the treatment of patients with recurrent endometrial cancers.

In the first report of the full cohort of 119 patients in the CheckMate-142 study, positive results were demonstrated with nivolumab alone or in combination with ipilimumab in patients with previously treated microsatellite instability-high or DNA mismatch repair-deficient metastatic colorectal cancer.

Daratumumab (Darzalex) in combination with&nbsp;bortezomib (Velcade), melphalan, and prednisone received FDA approval as a frontline regimen for the treatment of&nbsp;patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant.