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1st Annual European Congress on Immunotherapies in Cancer™

1st Annual European Congress on Immunotherapies in Cancer™


PER Pulse™ Recap

Resources

Community Practice Connections™: 1st Annual European Congress on Immunotherapies in Cancer™
Earn up to 1.5 AMA PRA Category 1 Credits™
This activity focuses on immunotherapies in melanoma, non–small cell lung cancer, and gastric cancer; it consists of a series of brief video interviews of leading and short summaries of clinical data related to issues discussed in the interviews. The content and videos are based on presentations given at the 1st Annual European Congress on Immunotherapies in Cancer™, held September 2016 in Barcelona, Spain. The program is designed for community oncologists and addresses currents standards of care and emerging concepts in cancer immunotherapy.

PER Pulse™ Recap
PER Pulse™ Recaps for Community Practice Connections™: 1st Annual European Congress on Immunotherapies in Cancer™ focuses on a series of video interviews with leading experts in immunotherapy for cancer that are featured in an online CME activity currently available at www.gotoper.com.


PER Pulse™ Recap

 

1 of 3
PER Pulse Recap

Community Practice Connections™: 1st Annual European Congress on Immunotherapies in Cancer™ is a series of short video interviews with the faculty of a CME-certified satellite symposium held September 2016 in Barcelona, Spain. In this online activity, leaders in immunotherapy for cancer discuss recent and emerging advances in melanoma, lung cancer, and gastric cancer. It features commentary by Antoni Ribas, MD, PhD, on resistance to immunotherapy; Roman Perez-Soler, MD, on single-agent and combination approaches across multiple lines of care in lung cancer; and Joseph Tabernero, MD, PhD, on new frontiers in immunotherapy for gastric cancer.

This first of 3 PER Pulse™ Recaps summarizing the program focuses on Dr. Ribas’ presentation and interview.

Therapies that target PD-1 (ie, nivolumab and pembrolizumab) elicit durable responses in patients with melanoma and other types of cancer. However, approximately 25% of patients who receive anti-PD-1 therapy for melanoma do not achieve a durable response. Additionally, even some patients who do achieve durable response experience delayed relapse that occurs years after initial objective tumor regression, even in the context of continuous therapy. The mechanisms for this acquired resistance are unknown. In his video interviews, Dr. Ribas describes recently published research results that provide some insights into how tumors develop resistance to checkpoint inhibitor therapy. Understanding the molecular mechanisms driving these adaptions is important across the multiple cancers for which this class of therapeutics is being used. Specifically, Dr. Ribas discusses:

  • Mechanisms of innate resistance to checkpoint inhibition in melanoma
  • Relevance of PD-L1 as a predictive marker for checkpoint blockade in tumors harboring constitutively activated PD-L1 versus those with PD-L1 reactive to the presence of T-cells
  • The varied clinical course of relapse observed among the approximately 30% of patients in whom objective response to immune checkpoint blocking therapy is lost
  • Very clear genetic patterns observed in tumors that acquire resistance to immune checkpoint blocking agents
  • How researchers are attempting to translate this knowledge into therapeutic strategies


2 of 3
PER Pulse™ Recap

Community Practice Connections™: 1st Annual European Congress on Immunotherapies in Cancer™ is a series of short video interviews with the faculty of a CME-certified satellite symposium held September 2016 in Barcelona, Spain. In this online activity, leaders in immunotherapy for cancer discuss recent and emerging advances in melanoma, lung cancer, and gastric cancer. It features commentary by Antoni Ribas, MD, PhD, on resistance to immunotherapy; Roman Perez-Soler, MD, on single-agent and combination approaches across multiple lines of care in lung cancer; and Joseph Tabernero, MD, PhD, on new frontiers in immunotherapy for gastric cancer.

This second of 3 PER Pulse™ Recaps summarizing the program focuses on Dr. Perez-Soler’s presentation and interview.

The introduction of targeted therapies has improved outcomes for patients with advanced lung cancer. At the end of the day, however, these agents have not dramatically improved 5-year overall survival. Checkpoint inhibitor agents in lung cancer have given rise to the hope of long-term survival, and have even raised the question of whether cure is a possibility for a subset of patients who are long-term survivors after having received immunotherapy. Monoclonal antibodies against programmed cell death protein 1 (PD-1; nivolumab and pembrolizumab) and its ligand (PD-L1; atezolizumab) are immune checkpoint inhibitors approved for use in lung cancer. At 3 to 4 years of follow-up with the anti-PD-1 inhibitors, data suggest that long-term survival at 5 years of follow-up may be achieved. In his video interviews, Dr. Perez-Soler puts data from trials of nivolumab and pembrolizumab for lung cancer into clinical and historical perspective. He also discusses the practicality and utility of using PD-L1 expression staining as a predictive marker of benefit from checkpoint inhibition in lung cancer. Specifically, Dr. Ribas discusses:

  • Recently presented trial data that demonstrated a survival benefit with pembrolizumab as frontline therapy for advanced non-small cell lung cancer (NSCLC) versus standard 2-drug chemotherapy in patients with >50% expression of PD-L1
  • A similar trial of frontline nivolumab therapy was negative, but enrolled patients without selection for PD-L1 expression
  • Collectively, these and other data support PD-L1 expression as a predictor of response and clinical benefit
  • The “impressive and encouraging” 3-year survival data from the KEYNOTE 001 study of pembrolizumab in patients with >50% PD-L1 expression
  • Immunotherapy-containing combinations that have produced promising results in early clinical studies, including PD-1 and CTLA4 inhibition and PD-1 inhibition with chemotherapy
  • His approach toward treatment selection in the second line of therapy for patients with NSCLC

3 of 3
PER Pulse™ Recap

Community Practice Connections™: 1st Annual European Congress on Immunotherapies in Cancer™ is a series of short video interviews with the faculty of a CME-certified satellite symposium held September 2016 in Barcelona, Spain. In this online activity, leaders in immunotherapy for cancer discuss recent and emerging advances in melanoma, lung cancer, and gastric cancer. It features commentary by Antoni Ribas, MD, PhD, on resistance to immunotherapy; Roman Perez-Soler, MD, on single-agent and combination approaches across multiple lines of care in lung cancer; and Joseph Tabernero, MD, PhD, on new frontiers in immunotherapy for gastric cancer.

This third of 3 PER Pulse™ Recaps summarizing the program focuses on Dr. Tabernero’s presentation and interview.

Altered proteins that result from genetic mutations in cancer present neoepitopes for immune recognition. Certain cancers have been shown to bear a heavier mutational burden than others. Colorectal and stomach cancers, as well as esophageal adenocarcinoma, are among tumor types associated with the highest somatic mutation frequency. In his video interviews, Dr. Tabernero discusses the mutational load of gastric cancers, along with other data that provide a rationale for use of PD-1/PD-L1 inhibition in gastric cancer. Specifically, Dr. Ribas discusses:

  • Results from studies of immune checkpoint inhibitors in gastric cancers are promising, especially when considering typical survival seen among patients with advanced, progressive disease after standard therapy.
  • The limited population of patients with gastric cancers who respond to single-agent immune checkpoint therapy. The challenge is to find new combinations and to define those who will benefit from checkpoint blockade. Data from ongoing phase III studies will provide valuable information on the benefits of checkpoint inhibition to the global population of patients with gastric cancer.
  • The strong rationale that underlies investigations of using PD-1/PD-L1 inhibitors in combination with other therapies. Ongoing, early-phase studies are evaluating the activity when PD-1 or PD-L1 inhibitors are combined with other immunotherapeutic approaches, targeted agents, or chemotherapeutics.
  • The important relationship that exists between gastric tumors and their microenvironment, including the stroma, inflammation, the immune component, and angiogenesis, as well as the macrobiota.







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