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
Thomas Powles, MD, PhD, of Barts Cancer Institute and the University of London, and Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, discuss clinical outcomes of sacituzumab govitecan-hziy after prior exposure to enfortumab vedotin-ejfv in patients with metastatic urothelial carcinoma, as well as the safety and efficacy of fam-trastuzumab deruxtecan-nxki in patients with HER2-expressing bladder tumors (Abstracts 4502 and 4509).
The ASCO Post Staff
Milana Bergamino Sirvén, MD, PhD, of Spain’s Institute of Cancer Research, discusses her findings on molecular profiling of patients with estrogen receptor–positive, HER2-positive early-stage breast tumors after short-term preoperative endocrine therapy. This study suggests that such profiling may help clinicians identify those patients with a favorable prognosis for adjuvant endocrine therapy and those who may require additional treatment (Abstract 560).
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
David J. Andorsky, MD, of the Sarah Cannon Research Institute and Rocky Mountain Cancer Centers, discusses EPCORE NHL-6, an ongoing study of patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). As outpatients, the study participants were given subcutaneous epcoritamab-bysp to see whether they could be safely monitored and cytokine-release syndrome appropriately managed in the outpatient setting (Abstract 7029).
The ASCO Post Staff
Axel Hauschild, MD, of Germany’s University of Kiel and University Hospital Schleswig-Holstein, discusses phase III study results on neoadjuvant intralesional daromun vs immediate surgery for patients with fully resectable, locally advanced melanoma (Abstract LBA9501).