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
Laurence Albiges, MD, PhD, of Gustave Roussy, Université Paris-Saclay, discusses phase III findings showing that high baseline serum KIM-1 levels were associated with poorer prognosis but improved clinical outcomes with atezolizumab vs placebo in patients with renal cell carcinoma at increased risk of recurrence after resection. Increased post-treatment KIM-1 levels were found to be associated with worse disease-free survival (Abstract 4506).
The ASCO Post Staff
Yeon Hee Park, MD, PhD, of South Korea’s Samsung Medical Center and Sungkyunkwan University, discusses phase II findings on palbociclib plus exemestane with a GnRH agonist vs capecitabine in premenopausal patients with hormone receptor–positive, HER2-negative metastatic breast cancer (LBA1002).
The ASCO Post Staff
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).
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.
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).