ASCO 2015 Highlights

National Harbor, MD—Patients with recurrent metastatic cervical cancer surpassed all historical standards for 1-year survival when treated with an investigational immunotherapy targeting human papillomavirus (HPV) infection.

National Harbor, MD—Patients with relapsed high-grade ovarian cancer with BRCA mutation derived the greatest benefit from the poly ADP-­ribose polymerase (PARP) inhibitor rucaparib (Rubraca) if their disease remained platinum sensitive, a new analysis of a large phase 2 clinical trial showed, as reported at the 2017 Society of Gynecologic Oncology meeting.

Orlando, FL—Prophylaxis with letermovir beginning after hematopoietic-­cell transplantation (HCT) and lasting through 100 days reduced the risk for clinically significant cytomegalovirus (CMV) infection. Furthermore, letermovir was associated with lower all-cause mortality compared with placebo, reported Francisco M. Marty, MD, Associate Professor of Medicine, Harvard Medical School, Boston, at the 2017 BMT Tandem Meetings.

Hollywood, FL—A basket study of the oncolytic immunotherapy PV-10 (10% Rose Bengal disodium for injection), which included patients with tumors originating in various locations, showed that data for gastrointestinal lesions were especially encouraging, reported Paul M. Goldfarb, MD, FACS, a surgeon at Oncology Associates of San Diego, CA, at the 2017 Clinical Interventional Oncology annual symposium.

Washington, DC—Preliminary data show excellent and durable responses to atezolizumab (Tecentriq) in 10% of women with triple-negative breast cancer, one of the most aggressive and difficult-to-treat cancers. Of the responders to atezolizu­mab, 100% were alive at 1 year compared with only 38% of nonresponders. The trick will be to identify which women will respond to immune checkpoint inhibitor therapy. Thus far, no biomarkers for response have been identified.

San Antonio, TX—Concentrations of tumor-infiltrating lymphocytes (TILs) had significant but variable associations with survival in breast cancer, according to 2 large retrospective studies of pathology specimens reported at the 2016 San Antonio Breast Cancer Symposium.

Orlando, FL—Enthusiasm for immunotherapy in the treatment of cancer must be balanced with a healthy respect for the power of T-cell activation. Autoimmunity is recognized as an effect of prolonged T-cell activation via PD-1/PD ligand 1 inhibition. Although immune-­related adverse events are generally easily managed, they occasionally can be fatal and therefore should be managed without delay, said Stephanie Andrews, MS, ANP-BC, a hospitalist specializing in medical oncology at Moffitt Cancer Center, Tampa, FL, at the 2017 National Comprehensive Cancer Network (NCCN) annual conference.

National Harbor, MD—Platinum-resistant ovarian cancer also appeared resistant to the immunotherapeutic effects of the toll-like receptor 8 (TLR8) agonist motolimod as add-on to chemotherapy, according to results of a randomized trial.

Washington, DC—Adding the investigational drug indoximod, an indole­amine 2,3-dioxygenase (IDO) pathway inhibitor, to the checkpoint inhibitor pembrolizumab (Keytruda) led to higher response rates in patients with advanced melanoma than what is reported with pembrolizumab monotherapy, said lead investigator Yousef Zakharia, MD, Clinical Assistant Professor of Internal Medicine, Division of Hema­tology, Oncology and Blood and Marrow Transplantation, University of Iowa, Iowa City, at the 2017 American Association for Cancer Research meeting.

Orlando, FL—Atezolizumab plus bevacizumab showed encouraging responses as a first-line treatment of metastatic renal-cell carcinoma in a phase 2 trial. Although the trial failed to meet its primary end point of significant improvement in progression-free survival (PFS) compared with sunitinib, the combination did reduce the risk for death or disease progression by 36% in patients with elevated PD ligand 1 (PD-L1) expression. The median PFS was almost double in the PD-L1–positive group with atezolizumab plus bevacizumab versus sunitinib (14.7 months vs 7.8 months, respectively).