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
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
Yucai Wang, MD, PhD, of the Mayo Clinic, discusses the increased efficacy of combination therapy with pembrolizumab plus a BCR kinase inhibitor compared with pembrolizumab alone in patients with Richter transformation of chronic lymphocytic leukemia (CLL; Abstract 7050).
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).
The ASCO Post Staff
Narjust Florez, MD, of the Dana-Farber Cancer Institute, and Suresh S. Ramalingam, MD, of Emory University School of Medicine, Winship Cancer Institute, discuss potentially practice-changing phase III results from the LAURA study. This trial showed that osimertinib after definitive chemoradiation therapy improved progression-free survival for patients with unresectable stage III EGFR-mutated non–small cell lung cancer (NSCLC), suggesting this agent may represent a new standard of care in this setting (LBA4).
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.
