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
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
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
Amrita Y. Krishnan, MD, of the City of Hope Cancer Center, and Paula Rodríguez-Otero, MD, PhD, of Spain’s Cancer Center Clínica Universidad de Navarra, discuss data that appear to further support daratumumab plus bortezomib, lenalidomide, and dexamethasone as a new standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (Abstract 7502).
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
Mazyar Shadman, MD, MPH, of Fred Hutchinson Cancer Center, discusses a network meta-analysis showing that zanubrutinib appears to be the most efficacious Bruton’s tyrosine kinase (BTK) inhibitor for patients with high-risk relapsed or refractory chronic lymphocytic leukemia. It offers delayed disease progression and favorable survival and response, compared with alternative BTK inhibitors (Abstract 7048).