The Blog
Recent Advances in Cancer Immunotherapy from the American Society of Clinical Oncology Conference (May 30 – June 3, 2013).
June 17, 2013
Written by Raymond Wong, Ph.D.
This year’s American Society of Clinical Oncology (ASCO) conference was held in Chicago, IL on May 30 – June 3, 2013. For the second year in a row, cancer immunotherapy took center stage. Although I did not attend in person, members of the press reported that certain cancer immunotherapy sessions reached standing room only capacity, with lines of conference attendees extending out of auditorium doors – like trendy Los Angeles night clubs.
The most significant recent advance in cancer immunotherapy has been the clinical development of Nivolumab (anti-PD-1 antibody) for the treatment of melanoma, non-small cell lung cancer, and renal cell carcinoma. Nivolumab is an antibody that blocks a major regulator of the immune system, called Programmed Death-1 (PD-1). Treatment with Nivolumab is akin to releasing the emergency brake in an automobile. Nivolumab can trigger a cancer patient’s own immune system to mount an attack on their tumors.
Dr. Suzanne Topalian, M.D. (Johns Hopkins University, Baltimore, MD) reported that Nivolumab treatment can produce objective clinical responses in ~20-25% of patients with melanoma, non-small cell lung cancer, or renal cell carcinoma[1]. Anecdotal evidence suggests that among patients whose primary tumors are histologically positive for a biomarker called PD-L1 (Programmed Death Ligand-1, a protein that interacts with PD-1), objective clinical responses upon Nivolumab treatment may occur in as many as ~36% of patients[1]. Bristol-Myers Squibb, the maker of Nivolumab, is now advancing the drug to large randomized Phase 3 clinical trials.
Dr. Jedd Wolchok, M.D., Ph.D. (Memorial Sloan-Kettering, New York, NY) reported that combining Nivolumab with another immunotherapy, Yervoy® (FDA-approved for metastatic melanoma in 2011), can produce objective clinical responses in up to ~53% of treated melanoma patients[2]. Among the patients who responded to the combination treatment, all had tumor shrinkage of ~80% or more[2]. While these results still need confirmation in large Phase 3 clinical trials, they demonstrate that the human immune system can be leveraged to effectively treat established tumors.
It is currently unknown if Nivolumab can be effective in treating pleural mesothelioma. However, data from early phase clinical trials in other cancer types suggest that evaluating histological expression of PD-L1 among archives of preserved pleural mesothelioma clinical tumor specimens could be the first step in assessing what proportion of patients could potentially benefit from Nivolumab.
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