I spent this past weekend in Chicago covering the American Society of Clinical Oncologists (ASCO) annual meeting. There are quite a number of follow up stories from the weekend that will be published over the next few weeks; but first, here is a quick recap from “Melanoma Monday,” which featured some significant announcements in the melanoma world.
The final full day at ASCO started bright and early with an 8 a.m. Monday morning Immunotherapy press conference. The briefing featured four immunotherapy trials, three of which were melanoma-related (the fourth dealt with cervical cancer, ironically discussing TIL therapy similar to my first clinical trial).
Now, in the interest of full disclosure — I had access to some of the conference materials beforehand, which, of course, I took zero advantage of all weekend. And adding to my first-timer mishaps, I booked a flight that required me to leave during the afternoon Melanoma Abstracts session, which was basically the SportsCenter Highlights of what was being presented in the world of melanoma. (Rookie mistake.) So, some of this recap is pieced together after the fact. The highlights include:
- Yervoy becoming an adjuvant treatment option for Stage III melanoma patients; the short version is those patients have a longer time before melanoma recurs if they use Yervoy than if they did nothing at all after their melanoma resection. The next steps will be reporting an ongoing clinical trial that measures two different Yervoy doses against the current Stage III standard of care, Interferon. More on that later this week.
- Merck’s anti-PD-1 (now officially pembrolizumab) reported initial findings of Overall Survival (i.e. percentage of patients still alive) at 69% after one year and 62% after 1.5 years. These patients are still alive at a much higher rate than existing approved melanoma treatments at the same intervals. It also showed 72% of patients who had at least one tumor scan had tumor shrinkage, and 31% of those had tumor size shrink 80% or greater. This Phase I study, perhaps the largest ever in oncology clinical research history, is the basis for Merck’s FDA Priority Review status.
- Not to miss out on the PD-1 bonanza, Dr. Mario Sznol expanded on an initial date presented last year on treatment with Bristol-Myers Squibb’s anti-PD-1 drug nivolumab combined with Yervoy. Overall survival at one year was 85% and two years at 79%; unprecedented numbers for metastatic melanoma patients. Of those patients, 42% showed tumor shrinkage of greater than 80%, and 17% of patients showed a complete response.
While much smaller than the Merck trial (53 patients reporting data so far), the nivolumab/Yervoy results, if they can be borne out over a larger dataset, would confirm what many are already speculating — that PD-1 in combination with other treatments is offering dramatically improved results for melanoma patients. As a monotherapy, PD-1 will be approved soon and will give a huge bump in melanoma (and other cancers) treatment survival rates. The future of immunotherapy, and, perhaps, cancer treatments, may lie in finding treatment combinations that are greater than any single agent.