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Breast Cancer
Genomics/Genetics
Immunotherapy

Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer

Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast Cancer ...

Breast Cancer
Immunotherapy

Expert Point of View: Debu Tripathy, MD, and Hope S. Rugo, MD, FASCO

The ASCO Post asked Debu Tripathy, MD, Professor and Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, and Hope S. Rugo, MD, FASCO, Professor of Medicine, Director of Breast Oncology and Clinical Trials Education at the University of California San...

Breast Cancer
Immunotherapy

Datopotamab Deruxtecan Shows Activity in Advanced Triple-Negative Breast Cancer

Datopotamab deruxtecan, an antibody-drug conjugate directed against trophoblast cell surface antigen-2 (Trop-2), is showing promise as a treatment for relapsed or refractory advanced triple-negative breast cancer, according to early findings from the phase I TROPION-PanTumor01 trial presented...

Breast Cancer
Immunotherapy

Expert Point of View: Hope S. Rugo, MD, FASCO

The discussant of KEYNOTE-522 at the 2021 San Antonio Breast Cancer Symposium, Hope S. Rugo, MD, FASCO, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California San Francisco Comprehensive Cancer Center, commented: “We are clearly making...

Breast Cancer
Immunotherapy

KEYNOTE-522: Sensitivity Analyses Confirm Value of Neoadjuvant Pembrolizumab in Triple-Negative Breast Cancer

Updated results from the pivotal KEYNOTE-522 trial have confirmed the benefit of neoadjuvant therapy with pembrolizumab plus chemotherapy in patients with early triple-negative breast cancer.1 The results were presented at the 2021 San Antonio Breast Cancer Symposium by Peter Schmid, MD, PhD,...

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Anthony El-Khoueiry, MD

Anthony El-Khoueiry, MD, Member of the Section of Gastrointestinal Cancers, Director of the phase I program, and Associate Professor of Clinical Medicine at the Keck School of Medicine of the University of Southern California and USC Norris Comprehensive Cancer Center, said the findings of the...

Hepatobiliary Cancer
Immunotherapy

HIMALAYA Trial: First-Line Tremelimumab Plus Durvalumab Improves Overall Survival in Unresectable Hepatocellular Carcinoma

Patients with advanced, unresectable hepatocellular carcinoma may be gaining another first-line treatment option. In the global phase III HIMALAYA trial, a single priming dose of tremelimumab plus regular-interval durvalumab significantly improved overall survival, according to Ghassan K....

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Nilofer Azad, MD

Nilofer Azad, MD, Professor of Oncology at Johns Hopkins University School of Medicine and Co-Director of Cancer Genetics and Epigenetics at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, was invited to discuss the results of the phase III TOPAZ-1 study, which found an overall survival...

Hepatobiliary Cancer
Immunotherapy

TOPAZ-1: Overall Survival Prolonged With First-Line Immunotherapy Plus Chemotherapy in Biliary Tract Cancer

For the first time, a phase III study has shown an overall survival benefit for upfront treatment using immunotherapy plus chemotherapy in advanced biliary tract cancer. In the TOPAZ-1 trial, the addition of the anti–PD-L1 agent durvalumab to gemcitabine plus cisplatin significantly improved...

Lung Cancer
Immunotherapy

Sugemalimab After Concurrent or Sequential Chemoradiation for Unresectable Stage III NSCLC

In an interim analysis of the Chinese phase III GEMSTONE-301 study reported in The Lancet Oncology, Zhou et al found that the PD-L1 inhibitor sugemalimab prolonged progression-free survival vs placebo in patients with locally advanced unresectable stage III non–small cell lung cancer (NSCLC)...

Lung Cancer
Immunotherapy

PACIFIC Trial: 5-Year Survival Outcomes With Durvalumab After Chemoradiotherapy in Stage III NSCLC

As reported in the Journal of Clinical Oncology by Spigel et al, long-term follow-up of the phase III PACIFIC trial has shown maintained progression-free and overall survival benefits with consolidation durvalumab vs placebo after chemoradiotherapy in unresectable stage III non–small cell lung...

Gastroesophageal Cancer
Immunotherapy

CheckMate 648: Nivolumab Plus Chemotherapy or Ipilimumab vs Chemotherapy in Previously Untreated Advanced Esophageal Squamous Cell Carcinoma

As reported in The New England Journal of Medicine by Doki et al, the phase III CheckMate 648 trial has shown improved overall survival with nivolumab combined with chemotherapy or ipilimumab vs chemotherapy alone in patients with previously untreated advanced esophageal squamous cell carcinoma, in ...

Breast Cancer
Immunotherapy

Use of Autologous Metastasis Mutation–Reactive TILs in Metastatic Breast Cancer

In a National Institutes of Health study reported in the Journal of Clinical Oncology, Zacharakis et al found that treatment with autologous tumor-infiltrating lymphocytes (TILs) reactive to mutations in metastatic lesions produced responses in patients with metastatic breast cancer. Study Details...

gastroesophageal cancer
immunotherapy

Thierry André, MD, on Esophagogastric Adenocarcinoma: New Findings on Nivolumab and Ipilimumab

Thierry André, MD, of Sorbonne University and Saint-Antoine Hospital, discusses phase II results from the GERCOR NEONIPIGA study, which suggests neoadjuvant therapy with nivolumab and ipilimumab may be associated with a high pathologic complete response rate in patients with localized microsatellite instability–high or mismatch repair–deficient esophagogastric adenocarcinoma. This study raises the question of whether surgery could be delayed or avoided for some patients (Abstract 244).

colorectal cancer
immunotherapy

Romain Cohen, MD, PhD, on Metastatic Colorectal Cancer: Long-Term Follow-up on Nivolumab Plus Ipilimumab

Romain Cohen, MD, PhD, of Sorbonne University and Saint-Antoine Hospital, discusses phase II results of the GERCOR NIPICOL study, which suggests nivolumab plus ipilimumab at a fixed duration of 1 year continued to show durable activity in patients with chemoresistant microsatellite instability–high/mismatch repair–deficient metastatic colorectal cancer after 3 years of follow-up. Dr. Cohen points out there is now some question as to whether all patients need 2 years of therapy (Abstract 13).

Lung Cancer
Immunotherapy

Addition of Sugemalimab to Platinum-Based Chemotherapy for Metastatic Squamous or Nonsquamous NSCLC

In the Chinese phase III GEMSTONE-302 trial reported in The Lancet Oncology, Caicun Zhou, MD, and colleagues found that the addition of the PD-L1 inhibitor sugemalimab to platinum-based chemotherapy improved progression-free survival in the first-line treatment of metastatic squamous or nonsquamous ...

colorectal cancer
immunotherapy

Melissa Amy Lumish, MD, on Rectal Cancer: PD-1 Blockade for Mismatch Repair–Deficient Disease

Melissa Amy Lumish, MD, of Memorial Sloan Kettering Cancer Center, discusses new findings showing a 100% complete response rate to PD-1 blockade alone among the first 11 patients with locally advanced mismatch repair–deficient rectal cancer treated with this approach. None of the patients required chemoradiation or surgery, thus avoiding their attendant morbidities, and so PD-1 blockade may represent a new treatment paradigm. Follow-up on the durability of response is needed (Abstract 16).

colorectal cancer
immunotherapy
genomics/genetics

Van K. Morris, MD, on Metastatic Colorectal Cancer: Early Trial Results on Encorafenib, Cetuximab, and Nivolumab

Van K. Morris, MD, of The University of Texas MD Anderson Cancer Center, discusses phase I/II data suggesting that encorafenib plus cetuximab and nivolumab is safe and well tolerated for patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer (Abstract 12).

Lymphoma
Immunotherapy

FDA Approves New Label Update for CAR T-Cell Therapy Axicabtagene Ciloleucel

On January 31, the FDA approved an update to the prescribing information for axicabtagene ciloleucel (Yescarta) to include use of prophylactic corticosteroids across all approved indications. Axicabtagene ciloleucel is now the first and only chimeric antigen receptor (CAR) T-cell therapy with...

Lung Cancer
Immunotherapy

Trastuzumab, Pertuzumab, and Docetaxel for Advanced HER2-Mutant NSCLC

In a French phase II trial (IFCT-1703-R2D2) reported in the Journal of Clinical Oncology, Julien Mazieres, MD, PhD, and colleagues found that the combination of trastuzumab, pertuzumab, and docetaxel produced durable responses in previously treated patients with advanced HER2-mutant non–small cell...

Lung Cancer
Immunotherapy

Addition of Radiotherapy to Durvalumab Plus Tremelimumab in Patients With Metastatic NSCLC Refractory to PD-1/PD-L1 Inhibitor Therapy

In a phase II trial reported in The Lancet Oncology, Jonathan Schoenfeld, MD, and colleagues found that the addition of low-dose or hypofractionated radiotherapy to durvalumab plus tremelimumab did not improve objective response rates in patients with metastatic non–small cell lung cancer (NSCLC)...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Zev A. Wainberg, MD, on Gastric or Gastroesophageal Junction Adenocarcinoma: Follow-up Data on Pembrolizumab and Chemotherapy

Zev A. Wainberg, MD, of the University of California, Los Angeles, discusses an update, of 25 additional months, on phase III safety and efficacy results from the KEYNOTE-062 trial. This study compared pembrolizumab with or without chemotherapy vs chemotherapy alone for patients with PD-L1–positive advanced gastric or gastroesophageal junction adenocarcinoma (Abstract 243).

Skin Cancer
Immunotherapy

Addition of Spartalizumab to Dabrafenib/Trametinib for BRAF V600–Mutant Advanced Melanoma

As reported in the Journal of Oncology by Reinhard Dummer, MD, and colleagues, the phase III COMBI-i trial has shown no significant progression-free survival benefit with the addition of the anti–PD-1 antibody spartalizumab to dabrafenib and trametinib in patients with no prior systemic treatment...

Gastroesophageal Cancer
Immunotherapy

Addition of Perioperative Trastuzumab to Neoadjuvant Chemoradiation for Patients With HER2-Overexpressing Esophageal Adenocarcinoma

As reported in The Lancet Oncology by Howard P. Safran, MD, and colleagues, the phase III NRG Oncology/RTOG-101 trial has shown no significant disease-free survival benefit with the addition of perioperative trastuzumab to neoadjuvant chemoradiation in previously untreated patients with...

Gynecologic Cancers
Immunotherapy

Lenvatinib/Pembrolizumab vs Chemotherapy in Previously Treated Patients With Advanced Endometrial Cancer

As reported in The New England Journal of Medicine by Vicky Makker, MD, and colleagues, the phase III Study 309-KEYNOTE-775 trial has shown prolonged progression-free and overall survival with lenvatinib plus pembrolizumab vs physician’s choice of chemotherapy among previously treated patients with ...

colorectal cancer
immunotherapy

Afsaneh Barzi, MD, PhD, on Colorectal Cancer: Early Data on Regorafenib and Pembrolizumab

Afsaneh Barzi, MD, PhD, of City of Hope Comprehensive Cancer Center and AccessHope, discusses results from a phase I/II study of regorafenib and pembrolizumab in refractory microsatellite-stable colorectal cancer. Although the trial did not meet its primary endpoint, the median overall survival is “provocative,” says Dr. Barzi. An analysis of biomarkers to identify patients with a longer duration of benefit is ongoing (Abstract 15).

hepatobiliary cancer
immunotherapy

Ghassan K. Abou-Alfa, MD, MBA, on Hepatocellular Carcinoma: Open-Label Trial of Tremelimumab and Durvalumab

Ghassan K. Abou-Alfa, MD, MBA, of Memorial Sloan Kettering Cancer Center and Weill Medical College at Cornell University, discusses phase III results of the HIMALAYA trial, which showed the combination of a single priming dose of tremelimumab added to durvalumab is superior to sorafenib for patients with unresectable hepatocellular carcinoma (Abstract 379).

hepatobiliary cancer
immunotherapy

Nilofer Saba Azad, MD, on Novel Treatment Combinations Under Study in Biliary Tract Cancers

Nilofer Saba Azad, MD, of Johns Hopkins Sidney Kimmel Cancer Center, assesses the findings from the phase III TOPAZ-1 trial, a study of durvalumab in combination with gemcitabine plus cisplatin in patients with advanced biliary tract cancer. Dr. Azad explains why the study sets a potential new standard of care of gemcitabine plus cisplatin and durvalumab in unselected patients.

Skin Cancer
Immunotherapy

Pembrolizumab for Adjuvant Treatment of Stage IIB or IIC Melanoma

On December 3, 2021, pembrolizumab was approved for adjuvant treatment of adult and pediatric (≥ 12 years of age) patients with stage IIB or IIC melanoma following complete resection.1 Supporting Efficacy Data Approval was based on findings in the phase III, double-blind KEYNOTE-716 trial...

Multiple Myeloma
Immunotherapy

Daratumumab/Hyaluronidase-fihj and Carfilzomib in Multiple Myeloma

On November 30, 2021, daratumu­mab/hyaluronidase-fihj and carfilzomib were approved for use in combination with dexamethasone for adults with relapsed or refractory multiple myeloma who had one to three prior lines of therapy.1,2 Supporting Efficacy Data Approval was based on findings in a cohort...

Leukemia
Lymphoma
Immunotherapy

Rituximab Plus Chemotherapy for Pediatric Mature B-Cell Non-Hodgkin Lymphoma and Mature B-Cell Acute Leukemia

On December 2, 2021, rituximab was approved for use in combination with chemotherapy for pediatric patients (≥ 6 months to 18 years) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, or mature B-cell acute leukemia.1...

Lung Cancer
Immunotherapy

Adjuvant Atezolizumab in IMpower010: Moving the Needle in Early-Stage NSCLC

Adjuvant platinum-based chemotherapy for early-stage non–small cell lung cancer (NSCLC) is currently almost an afterthought and is taken for granted as a standard of care for patients with stage II to IIIA NSCLC after resection. The earliest meta-analysis, published in 1995,1 gave the first hint of ...

Immunotherapy
Lung Cancer

Adjuvant Atezolizumab Improves Disease-Free Survival Following Adjuvant Chemotherapy in PD-L1–Positive Resected Stage II–IIIA NSCLC

As reported in The Lancet by ­Enriqueta Felip, MD, of Vall d’Hebron University Hospital, Barcelona, and colleagues, the phase III IMpower010 trial has shown improved disease-free survival with adjuvant atezolizumab vs best supportive care in the predefined population of patients with resected stage ...

Lung Cancer
Immunotherapy

Promise and Need for More Progress in Treatment of Squamous Cell NSCLC

A greater understanding of the mutational landscape in non–small cell lung cancer (NSCLC) has identified key oncogenes, such as EGFR, ALK, ROS, RET, and BRAF, among others. These discoveries, coupled with the availability of specific targeted small-molecule inhibitors, have transformed the...

Gastroesophageal Cancer
Immunotherapy

Pembrolizumab Plus Chemotherapy in Advanced Esophageal Cancer: Good News for Some, but More Work to Be Done

Multiple comparisons of traditional cytotoxic chemotherapy combinations that began decades ago led to the adoption of the platinum plus fluorouracil doublet as the standard of care for treatment of recurrent or metastatic esophageal cancer.1 Other combinations created by the addition and/or...

Lymphoma
Immunotherapy

BELINDA Trial: CAR T-Cell Therapy Fails to Improve Outcomes in Aggressive Non-Hodgkin Lymphoma

The autologous chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel failed to improve event-free survival vs standard-of-care treatment strategies in patients with aggressive, relapsed or refractory non-Hodgkin lymphoma (NHL), according to results of the phase III BELINDA trial,...

Skin Cancer
Immunotherapy

Circadian Timing of Immune Checkpoint Inhibitors: Beyond Good Times and Bad Times

After almost a century of limited efficacy of cancer immunotherapy,1 the breakthrough happened in 2012 with the discovery of immune checkpoint inhibitors,2,3 leading to the 2018 Nobel Prize in Physiology or Medicine for James P. Allison and Tasuku Honjo. Yet about 40% of patients on immune...

Skin Cancer
Immunotherapy

Metastatic Melanoma: Improved Overall Survival Reported With Immunotherapy Infusions Given Earlier in the Day

In a single-institution study reported in The Lancet Oncology, David C. Qian, MD, PhD, and Zachary S. Buchwald, MD, PhD, of Winship Cancer Institute of Emory University, Atlanta, and colleagues found that patients with metastatic melanoma who received at least 20% of immune checkpoint inhibitor...

colorectal cancer
immunotherapy

Heinz-Josef Lenz, MD, on Colorectal Cancer: Update From the CheckMate 9X8 Trial on Nivolumab, mFOLFOX6, and Bevacizumab

Heinz-Josef Lenz, MD, of USC Norris Comprehensive Cancer Center, discusses phase II results from the CheckMate 9X8 study, which compared nivolumab plus fluorouracil/leucovorin/oxaliplatin (mFOLFOX6) and bevacizumab vs mFOLFOX6 and bevacizumab in the first-line treatment of metastatic colorectal cancer. A subgroup of patients may benefit from adding nivolumab to the standard of care in this setting (Abstract 8).

Lung Cancer
Immunotherapy

T-DXd for Previously Treated Patients With Metastatic HER2-Mutant NSCLC

In the phase II DESTINY-Lung01 trial reported in The New England Journal of Medicine, Bob T. Li, MD, PhD, MPH, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) showed durable activity in patients with metastatic HER2-mutant non–small cell lung cancer (NSCLC) refractory to standard...

Breast Cancer
Immunotherapy

Long-Term Outcomes After Neoadjuvant Chemotherapy With or Without Carboplatin and Bevacizumab for Triple-Negative Breast Cancer

In an analysis from the phase II CALGB 40603/Alliance trial reported in the Journal of Clinical Oncology, Shepherd et al found that the addition of carboplatin or bevacizumab to neoadjuvant chemotherapy was not associated with improved long-term outcomes in patients with stage II or III...

Gynecologic Cancers
Immunotherapy

Pembrolizumab in Previously Treated Patients With MSI-H/dMMR Endometrial Cancer

As reported in the Journal of Clinical Oncology by David M. O’Malley, MD, and colleagues, pembrolizumab showed durable activity in a cohort of patients with microsatellite instability–high or mismatch repair–deficient (MSI-H/dMMR) advanced endometrial cancer enrolled in the multicohort KEYNOTE-158...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Kohei Shitara, MD, on Gastric and Esophageal Cancers: Long-Term Follow-up on Nivolumab Plus Chemotherapy

Kohei Shitara, MD, of Japan’s National Cancer Center Hospital East, discusses a long-term data follow-up from CheckMate 649, which support the continued use of nivolumab plus chemotherapy as first-line treatment in patients with advanced gastric, gastroesophageal junction, and esophageal adenocarcinomas (Abstract 240).

Immunotherapy

Combination Therapies May Improve Outcomes Due to Independent, Rather Than Synergistic or Additive, Drug Action

Independent drug action—not synergy nor additivity—accounted for the clinical efficacy of nearly all examined combination therapies involving immune checkpoint inhibitors in clinical trials, according to results from a retrospective analysis published by Palmer et al in Clinical Cancer Research....

Hepatobiliary Cancer
Immunotherapy

Durvalumab/Tremelimumab Improves Overall Survival vs Sorafenib in Patients With Advanced Hepatocellular Carcinoma: HIMALAYA

Results from the randomized international phase III HIMALAYA trial showed that a combination of the anti–PD-L1 immunotherapy durvalumab plus the anti–CTLA-4 immunotherapy tremelimumab reduced the risk of death by 22% in patients with stage III or IV unresectable hepatocellular carcinoma compared to ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of Nivolumab to Oxaliplatin-Based Chemotherapy for HER2-Negative, Unresectable, Advanced or Recurrent Gastric or Gastroesophageal Junction Cancer

In an Asian phase II/III trial (ATTRACTION-4) reported in The Lancet Oncology, Yoon-Koo Kang, MD, and colleagues found that the addition of nivolumab to oxaliplatin-based chemotherapy improved progression-free survival—but not overall survival—as first-line treatment of HER2-negative, unresectable, ...

immunotherapy

Yevgeniy R. Semenov, MD, on Cutaneous Immune-Related Adverse Events and Response to Immune Checkpoint Inhibitors

Yevgeniy R. Semenov, MD, of Massachusetts General Hospital and Harvard Medical School, discusses new findings suggesting cutaneous adverse events such as vitiligo, lichenoid dermatitis, and psoriasis—which often occur in patients with cancer who receive immune checkpoint inhibitors—may be strongly associated with response to therapy and a 22% reduction in mortality (Abstract 814).  

Hepatobiliary Cancer
Immunotherapy

Durvalumab Plus Gemcitabine/Cisplatin Improves Survival in Patients With Advanced Biliary Tract Cancer: TOPAZ-1

Biliary tract cancer is a rare and often fatal disease comprised primarily of bile duct and gallbladder cancers; it is diagnosed in about 12,000 individuals each year in the United States. The cancer has a 5-year relative survival rate of 25% for localized intrahepatic bile duct cancers and just...

Lung Cancer
Immunotherapy

Durvalumab/Tremelimumab With or Without Radiotherapy in Resistant NSCLC

In a recent phase II clinical trial, the combination of the PD-L1 inhibitor durvalumab and the CTLA-4 inhibitor tremelimumab curtailed tumor growth in some patients with non–small cell lung cancer (NSCLC) that was resistant to a single immunotherapy agent. The addition of radiation therapy to the...

Kidney Cancer
Immunotherapy

First-Line Nivolumab/Cabozantinib vs Sunitinib for Advanced Renal Cell Carcinoma: Patient-Reported Outcomes

In an analysis from the phase III CheckMate 9ER trial reported in The Lancet Oncology, David Cella, PhD, FASCO, and colleagues found that nivolumab/cabozantinib was associated with maintained or improved patient-reported outcomes vs sunitinib in the first-line treatment of advanced renal cell...

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