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
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
Lisa A. Carey, MD, of the University of North Carolina, Chapel Hill and UNC Lineberger Comprehensive Cancer Center, and Dejan Juric, MD, of the Massachusetts General Hospital Cancer Center, discuss phase III findings on first-line use of inavolisib or placebo plus palbociclib and fulvestrant in patients with PIK3CA-mutated, hormone receptor–positive, HER2-negative locally advanced or metastatic breast cancer who relapsed within 12 months of completing adjuvant endocrine therapy (Abstract 1003).
The ASCO Post Staff
Lisa A. Carey, MD, of University of North Carolina, Chapel Hill and UNC Lineberger Comprehensive Cancer Center, and Kevin Kalinsky, MD, of the Winship Cancer Institute of Emory University, discuss the first phase III findings showing a benefit of continued CDK4/6 inhibition with abemaciclib plus fulvestrant, following disease progression in patients with hormone receptor–positive, HER2-negative advanced breast cancer (LBA1001).
The ASCO Post Staff
Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Susan Halabi, PhD, of the Duke Cancer Institute and Duke University School of Medicine, discuss a clinical-genetic model that identified novel circulating tumor DNA alterations that are prognostic of overall survival and may help to classify patients with metastatic castration-resistant prostate cancer into risk groups useful for selecting trial participants (Abstract 5007).
The ASCO Post Staff
Don S. Dizon, MD, of Legorreta Cancer Center at Brown University and Lifespan Cancer Institute, discusses final phase II results of the BrUOG 354 trial showing that, for patients with ovarian and other extrarenal clear cell cancers, nivolumab and ipilimumab warrant further evaluation against standard treatment, given the historically chemotherapy-resistant nature of the disease (LBA5500).