Clifford A. Hudis, MD
More recently, non-small cell lung cancer (NSCLC) has become a focus for the next generation of immune-based therapeutic strategies. Immunotherapy, in particular the use of monoclonal antibodies that block inhibitory immune checkpoint molecules and therefore enhance the immune response to tumors, also has shown clinical promise in advanced solid tumors.
Research findings from clinical trials testing immunotherapies have been highlighted at major oncology conferences throughout 2013, including this year’s meeting of the American Society of Clinical Oncology (ASCO), where the most promising results came from an emerging class of antibodies that target the programmed death-1 (PD-1) pathway to take the brakes off the patient’s immune system, employing the same type of “checkpoint blockade” approach that the monoclonal antibody ipilimumab (Yervoy) pioneered in metastatic melanoma and which received FDA approval in 2011.
In 2010, sipuleucel-T (Provenge) was approved by the FDA for the treatment of metastatic, castration-resistant prostate cancer based on the results of the IMPACT (Immunotherapy Prostate Adenocarcinoma Treatment) trial in which it improved OS by 4.1 months and reduced the risk of death by 22% versus placebo.1,2 Despite these successes, immunotherapy has previously faced skepticism and significant disappointment; however, it is now beginning to gather momentum, particularly since the discovery of the immune checkpoints and the success of their therapeutic targeting.
The Cancer Research Institute, a New York City nonprofit that provides funding to scientists in the field, notes on its website that more than 1050 cancer immunotherapy clinical trials are now enrolling patients across a range of tumor types, many of which are phase III trials. (http://www.cancerresearch.org/)
In an OncLiveTV interview during the 2013 ASCO Annual Meeting, Clifford A. Hudis, MD, ASCO president, chief of the Breast Cancer Medicine Service, and attending physician, Memorial Sloan-Kettering Cancer Center in New York City, discussed his optimism surrounding immunotherapy for cancer care.
“What we now have is evidence that combinations of drugs can be effective,” with never-seenbefore results in metastatic melanoma.
“I’m optimistic about this for two reasons,” he continued. “The first is the narrow application in melanoma, a very difficult to treat disease, historically. Second, these results may well predict a future where we can manipulate the immune system productively to treat a variety of metastatic solid tumors. I’m very optimistic that we will see rapid expansion of this kind of immunology research across tumor types.”
What does this mean for the oncology nurse practicing today? Over the course of the next month, Oncology Nursing News will present some of the latest cancer immunotherapy research, with a focus on new clinical findings in the development of PD-1/PDL1– targeting agents. We will also feature opinions from oncology nursing professionals on how these therapies are reshaping clinical practice as they work to educate patients and help them to proactively and safely manage any immune-related adverse events.
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