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
Belinda Lee, MBBS, of Peter MacCallum Cancer Centre, Northern Health, Walter & Eliza Hall Institute, Melbourne, discusses findings from the AGITG DYNAMIC-Pancreas trial on the potential role of serial circulating tumor DNA testing after upfront surgery to guide adjuvant chemotherapy for early-stage disease (Abstract 107).
The ASCO Post Staff
Omid Hamid, MD, of The Angeles Clinic and Research Institute, a Cedars-Sinai affiliate, discusses updated data on IMC-F106C, a novel bispecific protein that, in a phase I safety and efficacy study, exhibited clinical activity in patients with unresectable or metastatic cutaneous melanoma who were pretreated with immune checkpoint inhibitors. A phase III trial of IMC-F106C with nivolumab in the first-line setting of metastatic disease has been initiated (NCT06112314; Abstract 9507).
The ASCO Post Staff
Jeanne Tie, MD, MBChB, of Peter MacCallum Cancer Centre, discusses data on survival and updated 5-year results from the DYNAMIC trial, which supports a role for circulating tumor DNA (ctDNA) analysis, including serial sampling, in the management of patients with stage II colon cancer (Abstract 108).
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
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.
