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
Thomas Powles, MD, PhD, of Barts Cancer Institute and the University of London, and Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, discuss clinical outcomes of sacituzumab govitecan-hziy after prior exposure to enfortumab vedotin-ejfv in patients with metastatic urothelial carcinoma, as well as the safety and efficacy of fam-trastuzumab deruxtecan-nxki in patients with HER2-expressing bladder tumors (Abstracts 4502 and 4509).
The ASCO Post Staff
Axel Hauschild, MD, of Germany’s University of Kiel and University Hospital Schleswig-Holstein, discusses phase III study results on neoadjuvant intralesional daromun vs immediate surgery for patients with fully resectable, locally advanced melanoma (Abstract LBA9501).
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).
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
Denise A. Yardley, MD, of the Sarah Cannon Research Institute, discusses the NATALEE trial, which assessed ribociclib plus a nonsteroidal aromatase inhibitor (NSAI) vs an NSAI alone in patients with hormone receptor–positive/HER2-negative early breast cancer at increased risk of recurrence, including patients with node-negative disease, and showed a benefit in invasive disease–free survival (Abstract 512).
