Immunotherapy
The advent of immunotherapy has led to durable clinical responses in a variety of malignancies, but identifying which patients will respond to treatment remains elusive.
The relative lack of progress in the treatment of malignant pleural mesothelioma is in marked contrast to developments in the treatment of lung cancer overall, but several ongoing studies using different immune-based therapies have shown promise in the treatment of this type of cancer.
Response is a poor outcome measure of immunotherapy, according to Tanguy Seiwert, MD, who addressed this and other concerning issues in immunotherapy at the 2016 Multidisciplinary Head and Neck Cancer Symposium.
With the surge in new immunotherapies becoming available for the treatment of melanoma, non-small-cell lung cancer (NSCLC), bladder cancer, and other solid tumors, it is important to know how to assess response patterns that differ from those of chemotherapy, manage the unique side effects, and understand the mechanisms of action of these drugs.
Despite the promise of molecular profiling, approximately 80% of patients with lung cancer lack a defined genotypic mutation, and become resistant when treated with a tyrosine kinase inhibitor.
Two programmed cell death receptor-1 (PD-1) inhibitors—the investigational drug nivolumab and the recently approved pembrolizumab (Keytruda)—produced dramatic responses in patients with Hodgkin lymphoma in phase 1 clinical trials.
The results of several studies show new prospects for treating patients with advanced melanoma. Three novel strategies use the body’s immune system to attack melanomas.
CHICAGO—Routine screening for hepatitis B virus (HBV) in all patients being started on immunosuppressive therapy uncovers a significant percentage with HBV surface antigen (HBsAg) and HBV core antibody (HBcAb), said Emmy Ludwig, MD, at the 2010 annual meeting of the American Society of Clinical Oncology (ASCO).
As such, she recommends a universal screening program for HBV at all cancer centers. Chemotherapy and immuno suppressive drugs can cause reactivation of HBV in persons who have the virus, with morbid and potentially fatal consequences.
