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Immunotherapy

Immunotherapy
Many patients with leukemia or lymphoma who receive treatment with anti-CD19 chimeric antigen receptor (CAR) T-cell therapy achieve minimum residual disease (MRD) negativity, and many are in complete remission well beyond 12 months. As such, CAR T-cell therapies are curing these patients.
Promising markers of response to immune checkpoint inhibition include tumor mutation burden (TMB) and genomic markers that reflect a disruption of the tumor immunity cycle, said Natalie Vokes, MD, MPhil, Medical Oncology Fellow, Dana-Farber Cancer Institute, Boston, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.
Chimeric antigen receptor (CAR) T-cell therapy is associated with unique adverse events that require vigilant monitoring, aggressive care, and specialized management. Marco L. Davila, MD, PhD, Medical Oncologist, Blood and Marrow Transplant and Cellular Immunotherapy Program, Moffitt Cancer Center, Tampa, FL, provided an overview of this topic at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.
Triple-negative breast cancer is considered one of the most difficult to treat breast cancers, with few treatment options, but finally a breakthrough study shows progress by extending patient survival.
Combining an immune checkpoint inhibitor and a tyrosine kinase inhibitor (TKI) significantly improved progression-free survival (PFS) in treatment-naïve patients with advanced renal-cell carcinoma (RCC) compared with a TKI alone.
The combination of immunotherapy with nivolumab (Opdivo) and ipilimumab (Yervoy) may soon represent a new first-line treatment option in patients with early-stage metastatic colorectal cancer (CRC) associated with microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) tumors.

The second-generation chimeric antigen receptor (CAR) T-cell therapy, bb2121, engineered to target B-cell maturation antigen, a protein on the surface of certain myeloma cells, displayed continuing efficacy and safety in an update of a phase 1 clinical trial in patients with relapsed or refractory multiple myeloma.

“The wide range of potential immune-related adverse events requires multidisciplinary, collaborative management by providers across the clinical spectrum,” according to Michael A. Postow, MD, and colleagues.

Among the 84 patients, 7 had partial responses with the combination of atezolizumab (Tecentriq) and cobimetinib (Cotellic). The median duration of response was 14.3 months.

The combination cohort consisted of 119 patients who received nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks for 4 doses followed by nivolu­mab 3 mg/kg every 2 weeks. The median follow-up was 13.4 months.

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