Immunotherapy, which harnesses the body’s immune system to attack cancerous cells, is proving so effective that in one British-led trial, more than half of patients with advanced melanoma saw tumours shrink or being brought under control, researchers said.
A number of trials of the drugs have been presented at the American Society of Clinical Oncology’s annual conference in Chicago.
Professor Roy Herbst, chief of medical oncology at Yale Cancer Centre in the US, described some of the findings as “spectacular”.
He said immunotherapy could replace chemotherapy as the standard treatment for cancer within the next five years, according to reports.
He told reporters: “I think we are seeing a paradigm shift in the way oncology is being treated.
“The potential for long-term survival, effective cure, is definitely there.”
High cost combination of nivolumab and ipilimumab proving more effective against advanced melanoma
The combination of nivolumab and ipilimumab significantly increased progression-free survival (PFS) for patients with advanced melanoma compared with ipilimumab alone, according to a randomized, double-blind, phase III trial (Abstract LBA1). Nivolumab monotherapy also performed better than ipilimumab alone. Though this was a positive trial, a Discussant also noted the extreme high costs of these drugs, and others like them.
In patients with PD-L1 expression of at least 5%, the median PFS was similar among the combination (14.0 months) and nivolumab monotherapy (14.0 months) arms, whereas the PFS was 3.9 months in the ipilimumab monotherapy arm.
Precision Medicine Trials
* The prospective, nonrandomized TAPUR clinical trial will collect information on the antitumor activity and toxicity of commercially available targeted cancer drugs in a range of cancer types (including advanced solid tumors, multiple myeloma, and B-cell non-Hodgkin lymphoma) with a genomic variation known to be a drug target. At launch, TAPUR will evaluate 10-15 drugs contributed by 5 pharmaceutical companies, with cohorts of up to 24 patients defined by tumor type, genomic abnormality, and drug. Patient enrollment is expected to open before the end of the year.
* The phase II NCI-MATCH trial will incorporate more than 20 different study drugs or drug combinations, each targeting a specific gene mutation, in order to match each patient in the trial with a therapy that targets a molecular abnormality in their tumor. Ten initial substudies are planned for the trial’s launch (Table 1), increasing to 20 or more within months. Patient enrollment will open in July 2015.
NCI-MATCH “is the largest, most rigorous precision oncology trial in history,” NCI Deputy Director James H. Doroshow, MD, said.
Trial investigators plan to screen at least 3,000 patients during the full course of the trial with the goal of enrolling approximately 1,000 patients in the various treatment arms (with up to 35 patients each). The trial’s design calls for at least one-quarter of the enrolled patients to have rare cancers (defined as cancers other than non–small cell lung, prostate, breast, or colon cancers).
SOURCES – American Society of Clinical Oncology