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
Eva M. Ciruelos, MD, PhD, of Spain’s Hospital 12 de Octubre and the Instituto de Investigación Sanitaria Hospital 12 de Octubre, discusses phase II data showing that the combination of palbociclib, trastuzumab, and endocrine therapy improved progression-free survival in patients with previously treated PAM50 luminal A or B, HER2-positive advanced breast cancer, as compared with treatment of physicians’ choice (Abstract 1008).
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
Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and Thomas Powles, MD, PhD, of Barts Cancer Institute and the University of London, discuss phase III findings from two studies: the first, investigating enfortumab vedotin-ejfv and pembrolizumab vs platinum-based chemotherapy in previously untreated patients with locally advanced or metastatic urothelial cancer; and the second, looking at nivolumab plus gemcitabine and cisplatin vs gemcitabine and cisplatin alone in patients with lymph node–only metastatic disease enrolled in the CheckMate 901 trial (Abstracts 4581 and 4565).
The ASCO Post Staff
Pierfranco Conte, MD, of the University of Padua, discusses phase III findings from the A-BRAVE trial, which was designed to evaluate the efficacy of avelumab, an anti–PD-L1 antibody, as adjuvant treatment for patients with early-stage triple-negative breast cancer who are at high risk (LBA500).
The ASCO Post Staff
Claudio Cerchione, MD, PhD, of Italy’s Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, discusses preliminary findings from a prospective trial suggesting that by adding whole-body MRI to fludeoxyglucose-18 (FDG) PET/CT scans, clinicians may detect bone lesions earlier and more accurately in patients with either newly diagnosed or relapsed multiple myeloma, thus translating into potentially better outcomes (Abstract 7512).
