Mar 7, 2019
Key Takeaways from the ASCO-SITC Clinical Immuno-Oncology with Dr. Steven Eric Finkelstein.
Welcome to the "ASCO Daily News podcast." I'm Lauren Davis and
joining me today is the "Immuno-oncology Daily News" Associate
Editor, Dr. Steven Eric Finkelstein with Florida Cancer Affiliates
the US Oncology Network. Dr. Finkelstein, welcome to the
podcast.
Thank you so much for having me. The Immuno-oncology Symposium just
concluded on Sunday. How was this event compared to last
year's?
Well, this year's event was, again, extremely exciting. This year's
event featured research and discussion surrounding themes of
patient-centered rational steps to move the field of
immuno-oncology towards the future. Now, as many of us know,
immuno-oncology has dramatically altered the treatment landscape
for many malignancies, and this progress has been extremely rapid
over the last decade.
As the field has progressed, researchers and clinicians are pushing
it towards a better understanding of how immunotherapy can affect
patients and the best and most rational combination approaches can
improve responses and long-term outcomes.
What presentations stood out to you?
Another exciting area of research was that the combination of
lenvatinib and pembro yielded promising antitumor activity and
progression-free survival in patients with metastatic urothelial
carcinoma. In abstract 11, a Phase Ib/II study was reported. And as
we know, urothelial cancer can account for 90% of all bladder
cancers.
Pembro monotherapy is currently approved as a first-line therapy in
patients who are ineligible to receive cisplatin or platinum-based
chemotherapy. It's also approved as a second-line treatment for
patients with advanced or metastatic urothelial cancer. Lenvatinib,
a multikinase inhibitor, a VEGFR-1 through 3, FGFR-1 through 4,
PDGFR-alpha, RET, and KIT is used as a single agent in several
malignancies, including thyroid cancer and hepatocellular
cancer.
Dr. Vogelzang, who presented the results of the study, discussed
the Phase II portion of the study, which included 20 patients with
histologically confirmed metastatic urothelial carcinoma. The
primary outcome in the trial was immune-related resist objective
response at 24 weeks. Five patients achieved such a response for an
overall response rate at 24 weeks of 25%.
Dr. Vogelzang's conclusion was that lenvatinib plus pembro
demonstrated promising antitumor activity with manageable adverse
events. The response rate warranted further investigation and
lenvatinib plus pembro combination will be studied in a Phase III
trial in urothelial carcinoma.
What other research were you interested in?
A Phase Ia/Ib trial was launched in order to evaluate the safety of
LY3321367, an anti-T cell immunoglobulin-domain and mucin-domain
containing molecule 3, or TIM-3 antibody. Administered alone or in
combination to LY3300054, which is an antiprogrammed death ligand,
or PD-L1 antibody in patients with advanced, relapsed, or
refractory solid tumors.
An analysis of the trial that was presented by Harding at the
meeting in Abstract 12. This focused on the safety, efficacy,
pharmacokinetics, and pharmodynamic results seen with these
treatment regimens. The key points are as follows--
treatment-related adverse reactions were mild, i.e. Grade two or
less, in both treatment groups except for one patient with a Grade
three anemia in Arm B.
No dose-limiting toxicities, dose-limiting equivalent toxicities,
treatment-related serious adverse events, or death was observed in
either treatment arm. Approximately 68% in Arm A and 88% in Arm B
of patients were positive for treatment emergent antidrug
antibodies related to the LY3321367. Despite antidrug antibodies,
there was no effect on pharmacokinetics noted
That's great. Were there any education sessions that caught your
attention?
I think at the 2019 ASCO SITC Clinical Immuno-Oncology Symposium,
what really struck me were the keynote addresses. On March 2, the
keynote lecture from Dr. Rafi Ahmed of Emory University examined
the basic scientific underpinnings of the field and focused deeply
on T cell exhaustion and differentiation.
In a second keynote address, Dr. Jedd Wolchok, of Memorial Sloan
Kettering, took a broader look of the future of immunotherapy. And
his main thesis was there was a need for a more rational approach
to combination therapies. Indeed, it is apparent that the
combination of therapies will be an important role for our
future.
That's wonderful. Were there any other takeaways that were
important during the symposium?
ASCO and the Society of Immunotherapy of Cancer, SITC, have really
focused on developing recommendations for clinical trial reporting.
Indeed, we need trial reporting that addresses the unique efficacy,
toxicity, combination, and sequencing aspects of immuno-oncology
treatments.
As many know, ASCO and SITC had convened a working group that
consisted of medical oncologists, immunologists, clinical research,
biostatisticians, and representatives from industry and government
to develop important recommendations, also known as Trial Reporting
in Immuno-oncology, or TRIO recommendations. The recommendations
based on expert consensus are important given that existing data to
support evidence-based recommendations are limited.
The recommendations given by TRIO are intended to improve the
reporting of IO clinical trials and thus, provide more complete
evidence on the relative benefits and risks of immuno-oncology.
Given the rapid expansion of the number of IO clinical trials and
ongoing improvements to evidence base using IO treatments and
clinical care, it is apparent that these recommendations will
likely need regular revision.
And the annual meeting of ASCO and SITC will be an important place
for TRIO recommendations to continually be updated.
Thank you. Again, today, my guest has been Dr. Steven Eric
Finkelstein. Thank you so much for being on our podcast today.
It's been an absolute pleasure. Thank you so much.
And to our listeners, thank you for tuning into the "ASCO Daily
News" podcast. If you're enjoying the content, we encourage you to
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