Immunotherapy Giving Hope for Cancer Patients

Posted on: July 1, 2015

By Dr. Gigi Chen

There have been exciting advances in the area of immunotherapy for the treatment of cancer in 2015.  Our immune system has the ability to differentiate self versus non-self.  It also plays an important role in controlling cancer. This year’s American Society of Clinical Oncology meeting highlighted some new immunotherapy treatments for a number of cancers including metastatic melanoma, metastatic lung cancer and colon cancer.

One drug called Ipilimumab (Yervoy), acts to increase the body’s immune response against cancer cells.  It is the first drug to be associated with an improvement in overall survival in patients with metastatic melanoma.   

Two other drugs: Nivolumab (Opdivo) and Pembrolizumab (Keytruda), were approved by the FDA in 2014 for the treatment of metastatic melanoma after progression during Yervoy treatment and, in patients with BRAF-mutated melanoma, after progression during treatment with a BRAF inhibitor. These drugs are monoclonal antibodies that target PD-1, a protein that inhibits T cell responses.  Blocking PD-1 pathway allows the immune system to recognize and target cancer cells, therefore has incredible promise as a therapeutic target.Ipilimumab Action

The plenary session at the American society of clinical oncology meeting this year highlighted the Checkmate 067 trial, which is a phase III trial of Opdivo alone or combined with Yervoy as first line treatment in patients with advanced melanoma. The study showed that Opdivo alone or combined with Yervoy resulted in significantly longer progression-free survival and higher response rate than Yervoy alone.  There are, however, more side effects associated with combination therapy which needs to be considered carefully.

In the area of lung cancer, patients with advanced squamous-cell lung cancer who have disease progression after first-line chemotherapy have had limited treatment options. There was a randomized international, phase III study that evaluated the efficacy and safety of Opdivo, as compared with standard chemotherapy Docetaxel (Taxotere). Overall survival, response rate, and progression-free survival were significantly better with Opdivo than Taxotere. Opdivo is now FDA approved for treatment of metastatic squamous cell lung cancer after progression on first line platinum based chemotherapy.

In the area of colon cancer, there was a small phase II study to evaluate the clinical activity of Keytruda in patients with progressive metastatic carcinoma. The researchers found overall survival rates to be superior for those patients who had mismatch repair–deficient colorectal cancer.

There were many other trials with encouraging results in immunotherapy.  Some of which include gastric, renal cell, hepatocellular, bladder and triple negative breast cancers and  Hodgkin’s lymphoma.  At Diablo Valley Oncology, we have been using these newer agents in our practice as well as participating in clinical trials. We are optimistic that the research is showing great success with therapies that tap patient’s immune system to help fight their disease.

Gigi Chen, MD is a medical oncologist and hematologist with Diablo Valley Oncology and Hematology Medical Group. She treats all types of cancers and blood disorders, with a special interest in lung and gynecologic cancers. For more information or to schedule an appointment, please call 925-677-5041.

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