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
Mazyar Shadman, MD, MPH, of Fred Hutchinson Cancer Center, discusses a network meta-analysis showing that zanubrutinib appears to be the most efficacious Bruton’s tyrosine kinase (BTK) inhibitor for patients with high-risk relapsed or refractory chronic lymphocytic leukemia. It offers delayed disease progression and favorable survival and response, compared with alternative BTK inhibitors (Abstract 7048).
The ASCO Post Staff
Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Samuel R. Denmeade, MD, of Johns Hopkins University School of Medicine, discuss a study showing that patients with metastatic castration-resistant prostate whose disease is progressing on abiraterone with androgen-receptor alterations detected in the blood may benefit from bipolar androgen therapy. Routine liquid biopsy testing may enable further adoption of bipolar treatment (Abstract 5003).
The ASCO Post Staff
Jean-Marc Classe, MD, PhD, of France’s Nantes Université, discusses phase III results showing that systematic lymphadenectomy should be omitted in patients with advanced epithelial ovarian cancer with clinically negative lymph nodes, as well as those undergoing neoadjuvant chemotherapy and interval complete surgery (LBA5505).
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
Toni K. Choueiri, MD, FASCO, of the Dana-Farber Cancer Institute, discusses phase III findings showing that, in patients with advanced renal cell carcinoma (RCC), the benefit of lenvatinib plus pembrolizumab vs sunitinib in overall response rate does not appear to be affected by such factors as gene‐expression signatures for tumor‐induced proliferation, PD‐L1 status, or the mutation status of RCC driver genes.
