Ezra Cohen, MD, PhD

Discussant for the abstract, Ezra Cohen, MD, PhD, of the University of California, San Diego, pointed out that although this subgroup may be responsive to checkpoint inhibition, it may not necessarily be anti–programmed cell death protein 1 (anti–PD-1) therapy.

“There are emerging data suggesting that other checkpoints and checkpoint inhibitors may be more effective in the prostate cancer setting,” said Dr. Cohen, who added that the tumor microenvironment and epigenetic T-cell modification may also explain the lack of response of prostate cancer to immune checkpoint blockade.

“We cannot apply the same tool to every patient just because their histology appears to be similar under the microscope,” he observed. “Rather, we must change the paradigm… and [learn to] fit the drug to the patient, not the patient to the drug.”

“Every cancer is different, and everybody’s immune system is different,” Dr. Cohen continued. “I truly believe that if we are going to take the next big steps in cancer therapy and immunotherapy, those are the paradigms we need to embrace.” ■

DISCLOSURE: Dr. Cohen has served as a consultant or advisor for AstraZeneca, Bristol-Myers Squibb, EMD Serono, Human Longevity, Merck, and Pfizer.