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 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).
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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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Peter Riedell, MD, of The University of Chicago, discusses phase III results on the use of tucidinostat plus R-CHOP in patients with previously untreated diffuse large B-cell lymphoma (DLBCL) with double expression of MYC and BCL2. The regimen appeared to improve event-free survival and complete response rates vs R-CHOP in the front-line setting. As this is an interim analysis, longer-term follow-up will be needed to better understand its impact, says Dr. Riedell.
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Tony S.K. Mok, MD, of The Chinese University of Hong Kong, discusses phase III findings from the KRYSTAL-12 study, which showed that adagrasib improved progression-free survival and overall response rate over docetaxel in patients with locally advanced or metastatic non–small cell lung cancer harboring a KRAS G12C mutation who had previously received a platinum-based chemotherapy with anti–PD-(L)1 treatment.
The ASCO Post Staff
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).