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
Reshma Jagsi, MD, DPhil, of Emory University Winship Cancer Institute, and Christian F. Singer, MD, MPH, of the Medical University of Vienna, discuss the MUC-1 vaccine tecemotide. When added to standard neoadjuvant systemic therapy for patients with early-stage breast cancer, this vaccine improved distant relapse–free and overall survival rates. Despite the exploratory nature of this observation, says Dr. Singer, this is the first long-term survival benefit of an anticancer vaccine in breast disease reported to date (Abstract 587).
The ASCO Post Staff
Eva M. Ciruelos, MD, PhD, of Spain’s Hospital 12 de Octubre and the Instituto de Investigación Sanitaria Hospital 12 de Octubre, discusses phase II data showing that the combination of palbociclib, trastuzumab, and endocrine therapy improved progression-free survival in patients with previously treated PAM50 luminal A or B, HER2-positive advanced breast cancer, as compared with treatment of physicians’ choice (Abstract 1008).
The ASCO Post Staff
Denise A. Yardley, MD, of the Sarah Cannon Research Institute, discusses the NATALEE trial, which assessed ribociclib plus a nonsteroidal aromatase inhibitor (NSAI) vs an NSAI alone in patients with hormone receptor–positive/HER2-negative early breast cancer at increased risk of recurrence, including patients with node-negative disease, and showed a benefit in invasive disease–free survival (Abstract 512).
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
Reshma Jagsi, MD, DPhil, of Emory University Winship Cancer Institute, and Tarah J. Ballinger, MD, of Indiana University Simon Comprehensive Cancer Center, discuss the disparate burden of taxane-induced peripheral neuropathy in Black women with early-stage breast cancer and how a tailored trial for this population showed that using docetaxel as the preferred taxane may be beneficial (LBA503).
