Best Practices in Immunotherapy – June/July 2017 Vol 8

One of the many responsibilities of a navigator is to facilitate patient education—it is therefore imperative that we educate ourselves on new treatments, distill the information into lay terms, and use that information to effectively educate our patients.
A new study has shown that combination immunotherapy can yield significant clinical benefits—even in heavily pretreated populations.
The FDA has granted accelerated approval to pembrolizumab for the treatment of any solid tumor in the body with a specific genetic feature, or biomarker.
The production of antibodies is the immune system’s way of waging an attack on something threatening. Monoclonal antibodies can be designed as immunotherapies that will attach to specific proteins on cancer cells, flag them for recognition by the immune system, and thus help decimate them.
Immunotherapy drugs are being approved for the treatment of more and more cancers and are making significant improvements in the lives of many patients. As a result, it has become vital that the oncology team, and navigators in particular, educate themselves and their patients on the mechanisms and side effects of these drugs.
New research into gut bacteria may shed light on the mystery of responsiveness to immunotherapy. The multi-institutional study, presented at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium, showed that patients with metastatic melanoma who responded to anti—PD-1 agents had increased diversity of intestinal microbiome.
When combined with chemotherapy, a vaccine against the human papillomavirus type 16 (HPV16) elicited strong T-cell responsiveness and improved clinical outcomes in patients with advanced cervical cancer.
According to data presented at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium, adoptive T-cell transfer using “nonengineered” T cells is producing durable responses in heavily pretreated patients with lymphoma or multiple myeloma.
With single-agent PD-1/PD-L1 therapy, melanoma patients are achieving outcomes once thought impossible for the disease, with some responses lasting more than a decade.
In patients with stage III/IV melanoma, intratumoral injections of plasmid interleukin-12 (IL-12) via electroporation enhanced response to immune checkpoint blockade.
The advent of immunotherapy has led to durable clinical responses in a variety of malignancies, but identifying which patients will respond to treatment remains an elusive goal.
As Dr Mita reported at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium, plinabulin is a small molecule with tumor-inhibiting and immune-enhancing effects.
Durability of benefit—the possibility for sustained remission in patients with previously incurable disease—is already one of the hallmarks of immunotherapy. According to recent statistical analysis, however, this durability may even exceed expectations.
According to data presented at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium, a single intravenous dose of an oncolytic virus can be highly effective in disseminated cancer as well.
According to preliminary data presented at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium, when used in combination with either ipilimumab or pembrolizumab, talimogene laherparepvec (T-VEC) demonstrated promising efficacy with minimal added toxicity.
Immune checkpoint therapy, specifically PD-1 blockade, has improved survival for patients with metastatic cancer, but not all patients respond to treatment.
Nivolumab as salvage treatment significantly reduced the risk for death after second-line or later chemotherapy in patients with advanced gastric or gastroesophageal junction cancer.

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