Christian U. Blank, MD, PhD, on Melanoma: Potentially Practice-Changing Results From the NADINA Trial
2024 ASCO Annual Meeting
Christian U. Blank, MD, PhD, of the Netherlands Cancer Institute, discusses findings of an investigator-initiated phase III trial showing that neoadjuvant ipilimumab plus nivolumab followed by response-driven adjuvant treatment improved event-free survival in patients with macroscopic, resectable stage III melanoma compared with adjuvant nivolumab (LBA2)
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
NADINA is the first phase III, investigator-initiated trial, testing a combination of neoadjuvant checkpoint inhibition against standard of care adjuvant therapy. NADINA showed that neoadjuvant ipilumumab plus nivolumab is superior to adjuvant nivolumab in the event free survival, showing that 83% at one year are rent-free in case of treated neoadjuvant versus only 57 treated with the standard of care adjuvant therapy.
Special about NADINA is also that it has a personalized adjuvant part. Patients achieving a deep response, what we call major pathologic response after the neoadjuvant part, didn't receive any subsequent other therapy, no adjuvant therapy, and started the follow-up at once, and this was the case in nearly 60% of the patients. And despite of only this six weeks of treatment, these patients have an excellent outcome with an event-free survival of 95% at 12 months.
Therefore, NADINA established for the first time a neoadjuvant combination scheme for macroscopic melanoma, but it also shows that we should personalize these neoadjuvant therapies, saving toxicity and resources for patients, achieving an excellent response after the neoadjuvant therapy. In that way, it establishes a really novel concept in macroscopic melanoma.
The ASCO Post Staff
Jens Marquardt, MD, of the University of Lübeck, and Jens Hoeppner, MD, of the University of Bielefeld, discuss findings from the ESOPEC trial, which showed that perioperative chemotherapy (fluorouracii, leucovorin, oxaliplatin, docetaxel) and surgery improves survival in patients with resectable esophageal adenocarcinoma when compared with neoadjuvant chemoradiation (41.4 Gy plus carboplatin and paclitaxel) followed by surgery (LBA1).
The ASCO Post Staff
Joseph A. Greer, PhD, of Massachusetts General Hospital and Harvard Medical School, discusses study findings showing the merits of delivering early palliative care via telehealth vs in person to patients with advanced lung cancer. Using telemedicine in this way may potentially improve access to and more broadly disseminate this evidence-based care model (LBA3).
The ASCO Post Staff
Pauline Funchain, MD, of Stanford University, and Caroline Robert, MD, PhD, of Gustave Roussy, discuss phase II findings showing that combining encorafenib and binimetinib followed by ipilimumab and nivolumab vs ipilimumab and nivolumab can improve progression-free survival in patients with BRAF-V600E/K-mutated melanoma characterized by high lactate dehydrogenase and liver metastases (Abstract LBA9503).
The ASCO Post Staff
Narjust Florez, MD, of Dana-Farber Cancer Institute, and David R. Spigel, MD, of Sarah Cannon Research Institute, discuss phase III findings showing that durvalumab as consolidation treatment after concurrent platinum-based chemoradiotherapy improved survival outcomes compared with placebo in patients with limited-stage small cell lung cancer. According to Dr. Spigel, these data support durvalumab as a new standard of care in this population (Abstract LBA5).
The ASCO Post Staff
Christos Kyriakopoulos, MD, of the University of Wisconsin Carbone Cancer Center, discusses data suggesting that adding cabazitaxel to abiraterone and prednisone improves progression-free survival in patients with metastatic castration-resistant prostate cancer who previously received chemohormonal therapy with docetaxel for hormone-sensitive disease compared with abiraterone plus prednisone alone (Abstract LBA5000).