Andrea Cercek, MD, on Rectal Cancer: Durable Complete Responses to PD-1 Blockade Alone
2024 ASCO Annual Meeting
Andrea Cercek, MD, of Memorial Sloan Kettering Cancer Center, discusses expanded data on the durability of complete response to dostarlimab-gxly, a PD-1 single-agent therapy administered to patients with locally advanced mismatch repair–deficient rectal cancer. The drug yielded recurrence-free responses, lasting longer than a year, without the need for chemotherapy, radiation, or surgery (LBA3512).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
We're presenting data on the durability of clinical complete responses in mismatch repair-deficient locally advanced rectal cancer to PD-1 therapy alone. We designed a phase II clinical trial of neoadjuvant PD-1 blockade with dostarlimab in mismatch repair-deficient rectal cancer, with the idea that we could use immunotherapy alone, dostarlimab alone to treat locally advanced rectal cancer, and potentially omit standard approaches to therapy, including chemotherapy, radiation, and surgery. And we initially presented the data two years ago. In June of 2022, we noted complete responses, 100% complete responses in 14 consecutive patients. So now we're presenting the expanded data. The trial has been ongoing, and we continue to see a hundred percent complete clinical responses now in 42 patients treated with dostarlimab.
None of our patients have needed chemotherapy, radiation, or surgery. The second primary endpoint of the trial was the durability of these complete responses. And we have seen now that 24 patients have had more than a year of complete clinical responses after completion of dostarlimab. Really showing that not only are we seeing 100% complete responses, but that these responses are in fact durable in patients. And in terms of quality of life, this has been incredibly impactful for patients. None have needed chemotherapy, radiation, or surgery. And we've seen very little toxicity, only grade 1 or 2 toxicity on trial to dostarlimab, so the patient's quality of life is maintained after treatment.
There is now a global study called AZUR-1 with the same exact design, looking at neoadjuvant therapy with dostarlimab in mismatch repair-deficient rectal cancer. Which is a registration study that will hopefully provide care to all patients with early-stage mismatch repair-deficient rectal cancer, and change the standard of care in this population.
The ASCO Post Staff
Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and Thomas Powles, MD, PhD, of Barts Cancer Institute and the University of London, discuss phase III findings from two studies: the first, investigating enfortumab vedotin-ejfv and pembrolizumab vs platinum-based chemotherapy in previously untreated patients with locally advanced or metastatic urothelial cancer; and the second, looking at nivolumab plus gemcitabine and cisplatin vs gemcitabine and cisplatin alone in patients with lymph node–only metastatic disease enrolled in the CheckMate 901 trial (Abstracts 4581 and 4565).
The ASCO Post Staff
Sherene Loi, MD, PhD, of Peter MacCallum Cancer Centre, discusses a circulating tumor DNA (ctDNA) analysis from a cohort of patients with early-stage breast cancer who were enrolled in the monarchE trial. This large cohort was studied to look at the usefulness of a personalized tumor-informed assay for ctDNA detection in early stage high-risk patients (LBA507).
The ASCO Post Staff
Suzanne Trudel, MD, of Canada’s Princess Margaret Cancer Centre, discusses phase III findings showing that, in patients with relapsed or refractory multiple myeloma who had one or more prior lines of treatment, belantamab mafodotin-blmf plus pomalidomide and dexamethasone improved progression-free survival and showed a favorable overall survival trend compared with pomalidomide plus bortezomib and dexamethasone.
The ASCO Post Staff
Yeon Hee Park, MD, PhD, of South Korea’s Samsung Medical Center and Sungkyunkwan University, discusses phase II findings on palbociclib plus exemestane with a GnRH agonist vs capecitabine in premenopausal patients with hormone receptor–positive, HER2-negative metastatic breast cancer (LBA1002).
The ASCO Post Staff
Mazyar Shadman, MD, MPH, of Fred Hutchinson Cancer Center, discusses an ongoing phase III study of the BCL2 inhibitor sonrotoclax plus zanubrutinib vs venetoclax and obinutuzumab for patients with treatment-naive chronic lymphocytic leukemia. The investigators are recruiting internationally (see NCT06073821; Abstract TPS7087).