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
Reshma Jagsi, MD, DPhil, of Emory University Winship Cancer Institute, and Christian F. Singer, MD, MPH, of the Medical University of Vienna, discuss the MUC-1 vaccine tecemotide. When added to standard neoadjuvant systemic therapy for patients with early-stage breast cancer, this vaccine improved distant relapse–free and overall survival rates. Despite the exploratory nature of this observation, says Dr. Singer, this is the first long-term survival benefit of an anticancer vaccine in breast disease reported to date (Abstract 587).
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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).
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Emily L. Podany, MD, of Washington University, St. Louis, discusses disparities in the use of PI3K inhibitors for Black patients with estrogen receptor–positive, HER2-negative metastatic breast cancer while other drugs that do not require genomic profiling were similarly used (Abstract 1017).
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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).
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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.
