Browsing Over 191 Presentations
Skin toxicities: Lessons for medical oncologists
- Mario Lacouture
- Mario Lacouture
Are rare toxicities becoming less rare?
- Salvador Martin Algarra
- Salvador Martin Algarra
How safe are PD1 inhibitors in the long run?
- Jeffrey Weber
- Jeffrey Weber
Release the brake with checkpoint inhibitors
- Inge Verbrugge
- Inge Verbrugge
Optimal trial design for radiotherapy and immune treatment
- Eric Deutsch
- Eric Deutsch
High-plex digital spatial profiling and 3D biology for developing predictive biomarkers for immuno-therapy
- Joseph Beechem
- Joseph Beechem
Discovering tumor biology with multiplexed immunohistochemistry and multispectral imaging
- Bjoern Wendik
- Bjoern Wendik
Analysis of the tumor immune landscape using multiplexed mass cytometry
- Stéphane Chevrier
- Stéphane Chevrier
Kick the immune system with immunocytokines
- Dario Neri
- Dario Neri
Durable remissions associated with anti-CTLA-4 and anti-PD1 checkpoint inhibitors in a single center
- Teresa Smit
- Teresa Smit
- Bernardo L. Rapoport
- Ronwyn I. Van Eeden
Abstract
Background
Treatment with the checkpoint inhibitors ipilimumab (IPI) and nivolumab (NIVO) are associated with durable remissions in patients (pts) with solid tumors. We describe the durable remissions associated with these agents. There were 19 pts treated with IPI and 25 pts treated with NIVO and 1 pt was treated with a combination of IPI and NIVO.
Methods
The purpose of this analysis is to describe the durable remissions associated with IPI and NIVO on a variety of solid tumors treated at a single centre. This is a retrospective data analysis from 45 pts treated either in an expanded access program, clinical trial setting or post-registration protocol.
Results
A total of 45 pts (30 males, 15 females) were analyzed. Three pts with metastatic malignant melanoma (MMM), 18 with non-small cell lung cancer (NSCLC), 2 with renal cell carcinoma (RCC) and 2 with Hodgkin’s disease (HD) were treated with NIVO and 19 with MMM received IPI. One NSCLC pt received a combination of IPI and NIVO (1 cycle). In total 167 cycles of NIVO (median = 4, range 1-16), and 64 cycles of IPI (median = 4 cycles, range 1-4) were administered. In the MMM group, there were 5 responses out 20 pts (25%) treated with IPI including 3 pts with durable complete response (CR) of 74+, 46+ and 34+ months. One MMM pt treated with NIVO has an ongoing partial response (PR) of 23 months. Among the pts with NSCLC 6 responses were documented among the 18 pts treated with NIVO (33%). Two of these pts had very good and durable PRs of 10+ and 18+ months. One RCC pt treated with NIVO has an ongoing PR of 13+ months. Two heavily pretreated pts with HD treated with NIVO have very good PRs of 14+ and 13+ months. Additionally, a very PR was documented in the NSCLC pt treated with the combination IPI and NIVO.
Conclusions
Anti-PD1 and anti-CTLA4 antibody treatment are associated with durable remissions in pts with a variety of solid tumours. Among our pts durable remissions and durable responses were documented in pretreated pts with RCC, NSCLC, HD and MMM.
Legal entity responsible for the study
Prof Bernardo L. Rapoport
Funding
None
Disclosure
B.L. Rapoport: MSD: Adboards, Speaker engagements, Consultancy, Contract Research; BMS: Adboards, Speaker engagements, Consultancy, Contract Research, Research grant. All other authors have declared no conflicts of interest.
Extended survival analysis of ipilimumab for the treatment of advanced malignant melanoma in pretreated patients: Five-year long-term follow-up of the South African expanded access program
- Bernardo L. Rapoport
- Bernardo L. Rapoport
- Daniel Vorobiof
- Lydia Dreosti
- Adam Nosworthy
- Georgina McAdam
- A Jordaan
- Margreet De Necker
- Janina De Beer
- Hennie Duvenhage
Abstract
Background
Ipilimumab is a human monoclonal IgG1 antibody against CTLA-4 that has been shown to prolong the overall survival of patients with advanced pretreated melanoma. In 2015, a retrospective, multi-centre, non-interventional analysis was per- formed on data collected from the ipilimumab expanded access programme in South Africa, with last follow-up date (or death) in December 2014. The current study extends this analysis by follow-up on the long-term survival of pre-treated metastatic patients up to September 2016.
Methods
Follow-up questions were sent to participating investigators, who had patients who were still alive (29) or for whom it was not known whether they were still alive (11) following the last ipilimumab infusion. Investigators had to confirm whether patients were still alive, the date of death or last contact, clinical response at last contact, and whether the patient was still responding to ipilimumab.
Results
Of the 108 patients, 84 (78%) had cutaneous melanoma and 24 patients (22%) had non-cutaneous melanoma, including uveal, mucosal, and melanoma of unknown primary. Twenty patients previously received two or more lines of treatment for metastatic melanoma. The median age was 59 years (range 27 – 86) and there were 73 (68%) males and 35 (32%) females. Baseline ECOG PS was 0 in 33%, PS 1 in 58% and PS 2 in 6% of patients. The longest follow-up time available was 5.4 years. The median OS was 9.36 months (95% CI 7.48 – 11.84). One-year survival was 39% (95% CI 29% - 48%), 2-year survival was 22% (95% CI 15% - 30%), 3-year survival was 19% (95% CI 12% - 27%), 4- and 5-year survival was 15% (95% CI 8% - 21%). In the group of cutaneous melanoma patients, the 4- and 5-year survival was 17% (95% CI 9% - 25%) while in the non-cutaneous group the 4- and 5-year survival was 6% (95% CI 0% - 16%).
Conclusions
Ipilimumab at a dose of 3mg/kg is an effective treatment for patients with pre-treated advanced (unresectable or metastatic) melanoma and is associated with durable remissions and long-term survival.
Clinical trial identification
CA184-515 Ethics approval extended on protocol REC 2/21/05/14
Legal entity responsible for the study
Prof Bernardo L. Rapoport
Funding
Investigator Sponsored Research (ISR) trough Bristol-Myers Squibb South Africa
Disclosure
B.L. Rapoport: BMS South Africa: Advisor, Speaker Bureau, Contract Research and Funded Research; MSD: Advisor, Speaker Bureau and Contract Research; AstraZeneca: Advisor, Speaker Bureau and Contract Research; Roche South Africa: Advisor, Speaker Bureau and Contract Research. H. Duvenhage: BMS: Medical Director. All other authors have declared no conflicts of interest.
Evaluating renal cell carcinoma treatment options using real world data: Findings from an oncology survey across seven countries
- Sheila Mpima
- Sheila Mpima
- Shruti Menon
- Paola Nasuti
- Hammit Mistry
Abstract
Background
Renal Cell Carcinoma (RCC) has always been considered an immunogenic tumour with immunostimulatory therapeutic approaches like interleukins and interferons being cornerstone in the 1990s. Clinical data supports the hypothesis that the PD-1/PDL1 interaction is an important regulator in tumour immune tolerance and tumour growth in RCC. No prognostic or predictive biomarkers have previously been identified leaving testing an unknown in RCC. The objective is to evaluate current real-world treatment patterns including PD-L1 expression testing in RCC.
Methods
This study used a QuintilesIMS oncology specific cross-sectional survey collecting anonymized patient-level oncology data in EU4 (France, Germany, Spain, UK) and Asia (China, Japan, Korea) between January – June 2017.
Results
Of the 2,413 surveyed patients, 79% were prescribed Tyrosine Kinase Inhibitors (TKIs), 7% mTOR inhibitors, 2% interferons/interleukins, 9% anti-PD-1/PD-L1 treatments (4% Asia vs 10% EU4). The majority of patients were prescribed anti-PD-1/PD-L1 treatments as monotherapy with under 1% prescribed in combination with TKIs. 97% of patients receiving an anti-PD-1/PD-L1 drug had completed another treatment prior to receiving checkpoint inhibitors while other 3% were new to treatment. The most common previous therapies were TKIs (82%) followed by mTOR inhibitors (26%), and the reason for discontinuation was primarily disease progression (86%).In 70% of patients treated with anti-PD1 treatments the disease metastasised to two or more organs. 22% of RCC patients were tested for PD-1/PDL1 expression in EU4 while none were tested in Asia.
Conclusions
PD-1/PD-L1 inhibitors are mainly being prescribed to patients with RCC that have completed at least one line of treatment and who have manifested disease progression. The precise role of PD-L1 positivity remains to be defined within this patient segment as testing rates for expression remain really low or non-existent in some countries. Further analysis will be required to understand the time to PD-1/PDL1 expression testing and to understand difference in typical patient profile of patients treated with standard of care vs anti-PD-1/PD-L1 treatments.
Legal entity responsible for the study
N/A
Funding
None
Disclosure
All authors have declared no conflicts of interest.