Advertisement


Sapna P. Patel, MD, on Melanoma: New Data on Pembrolizumab, Adjuvant vs Neoadjuvant Plus Adjuvant

ESMO Congress 2022

Advertisement

Sapna P. Patel, MD, of The University of Texas MD Anderson Cancer Center, discusses the latest findings from the SWOG S1801 trial, which showed that using single-agent pembrolizumab as neoadjuvant therapy improved event-free survival compared to adjuvant therapy in high-risk resectable stage III–IV melanoma (Abstract LBA6).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
The rationale behind neoadjuvant immunotherapy for melanoma is that cancer comes in contact with T cells that are inside the tumor. If you remove the tumor, you remove those T cells with it. On the other hand, if you give neoadjuvant therapy while the tumor is still in place and those T cells, you end up generating a larger immune response than if you give the same treatment after the tumor is removed. With that in mind, we designed the SWOG S1801 phase II trial. The study was a randomized one-to-one study for participants with stage IIIB to IV resectable melanoma. Participants on the adjuvant arm were randomized to surgery first followed by 18 doses of adjuvant pembrolizumab, flat-dosed every three weeks. Participants on the neoadjuvant arm received 3 doses of pembrolizumab followed by surgery, and then 15 doses of adjuvant pembrolizumab. Neoadjuvant therapy with pembrolizumab followed by adjuvant pembrolizumab improves event-free survival in resectable melanoma. Toxicities were well-managed and no new safety signals emerged. In fact, the use of neoadjuvant pembrolizumab did not lead to an increase in surgery events. Compared to the same therapy given entirely after surgery, the use of neoadjuvant pembrolizumab improves event-free survival in patients with resectable melanoma. The next steps for S1801 include central pathologic review on the neoadjuvant specimens to determine a correlation between pathologic response and clinical outcomes. Future neoadjuvant studies can consider S1801 as a benchmark and expand on deescalation of surgery protocols, deescalation of adjuvant therapy, or escalation of neoadjuvant or adjuvant regimens for those whose tumors do not respond.

Related Videos

Head and Neck Cancer
Immunotherapy

Jean-Pascal Machiels, MD, PhD, on Head and Neck Cancer: Recent Data on Pembrolizumab and Chemoradiation Therapy

Jean-Pascal Machiels, MD, PhD, of Belgium’s Cliniques universitaires Saint-Luc (UCLouvain), discusses the primary results of the phase III KEYNOTE-412 study of pembrolizumab plus chemoradiation therapy (CRT) vs placebo plus CRT for patients with locally advanced head and neck squamous cell carcinoma (Abstract LBA5).

Lung Cancer
Immunotherapy

Martin Reck, MD, PhD, on NSCLC: New Findings on Cemiplimab, Nivolumab, and Ipilimumab

Martin Reck, MD, PhD, of Germany’s Lung Clinic Grosshansdorf, details two trials that included patients with advanced non–small cell lung cancer: 3-year survival outcomes in the EMPOWER-Lung 1 study of continued cemiplimab-rwlc beyond disease progression with the addition of chemotherapy, and phase III results from the IFCT-1701 trial of nivolumab plus ipilimumab 6-month treatment vs treatment continuation (LBA54 and Abstract 972O).

Skin Cancer

Neil D. Gross, MD, on Cutaneous Squamous Cell Carcinoma: Recent Findings on Cemiplimab

Neil D. Gross, MD, of The University of Texas MD Anderson Cancer Center, discusses data from a phase II study, which showed that neoadjuvant cemiplimab-rwlc in patients with stage II–IV (M0) resectable cutaneous squamous cell carcinoma is active and may enable function-preserving surgery in some cases (Abstract 789O).

Prostate Cancer

Neal D. Shore, MD, on Prostate Cancer: Biomarker Analysis, Enzalutamide, and Active Surveillance

Neal D. Shore, MD, of Carolina Urologic Research Center/Genesis Care, discusses new data from the ENACT trial, which showed that patients with prostate cancer and the RNA biomarkers PAM50 and AR-A were likely to have better outcomes with enzalutamide treatment. The results suggest that such RNA biomarkers may help to identify patients who may benefit from enzalutamide treatment compared with active surveillance (Abstract 1385P).

Breast Cancer

Laurence Buisseret, MD, PhD, on Triple-Negative Breast Cancer: Chemoimmunotherapy With or Without an Anti-CD73 Antibody

Laurence Buisseret, MD, PhD, of Belgium’s Institut Jules Bordet, discusses phase II results from the SYNERGY trial, which tested first-line chemoimmunotherapy of durvalumab, paclitaxel, and carboplatin with or without the anti-CD73 antibody oleclumab in patients with advanced or metastatic triple-negative breast cancer. Although adding oleclumab to durvalumab with chemoimmunotherapy did not increase the clinical benefit rate at week 24, research is ongoing to better understand the mechanisms of response and resistance to this study combination (Abstract LBA17).

Advertisement

Advertisement




Advertisement