A Trifecta for Immunotherapy in Lung Cancer
This week the American Association for Cancer Research annual meeting has brought a trifecta of groundbreaking news for immunotherapy in lung cancer. Blockade of the PD-1/PD-L1 pathway, which results in the release of the immune system “brakes” and a powerful T cell response against cancer, is reaching its full potential in lung cancer.
These 3 studies found the following:
"Neoadjuvant nivolumab was associated with few side effects, did not delay surgery, and induced a major pathological response in 45% of resected tumors. The tumor mutational burden was predictive of the pathological response to PD-1 blockade. Treatment induced expansion of mutation-associated, neoantigen-specific T-cell clones in peripheral blood."
"Progression-free survival was significantly longer with first-line nivolumab plus ipilimumab than with chemotherapy among patients with NSCLC and a high tumor mutational burden, irrespective of PD-L1 expression level. The results validate the benefit of nivolumab plus ipilimumab in NSCLC and the role of tumor mutational burden as a biomarker for patient selection."
"In patients with previously untreated metastatic nonsquamous NSCLC without EGFR or ALK mutations, the addition of pembrolizumab to standard chemotherapy of pemetrexed and a platinum-based drug resulted in significantly longer overall survival and progression-free survival than chemotherapy alone."
Pathologist’s role
Pathologists are crucial in this new cancer battle. They are involved in each step of the process. First, a tumor may be biopsied in either the operating room or radiology under CAT scan guidance. Pathologists are called upon to assess the sample, ensuring it is adequate for both diagnosis and testing for precision medicine targets (“actionable mutations”).
In the lab, pathologists examine tissues under the microscope using various stains to make a diagnosis. When appropriate, a tumor is tested for the presence of “actionable mutations”. If discovered, the patient may be eligible for targeted therapy. The success of precision medicine depends on pathologists.
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6yImportant to see how TMB was scored in each study in order to address standardization of this useful bio marker approach to IO response prediction
Drug discovery | Biomarker discovery | Data Science | Bioinformatics
6yIt's interesting to see the mutation burden correlate with the response as you mentioned in the blog. Does the reason lies in low DNA repair causing higher mutation burden? If yes, combining chemo with immunotherapy may have more profound effect.
New molecules for precision oncology Innovative smart molecules for PD-1/PD-L1/CD19/CD25/CD38 therapy
6yTHE ROLE OF IMMUNOTHERAPY IS EXTREMELY IMPORTANT. But I am somewhat embarrassed, I quote: " In the lab, pathologists examine tissues under the microscope using various stains to make a diagnosis. When appropriate, a tumor is tested for the presence of “actionable mutations”. If discovered, the patient may be eligible for targeted therapy. The success of precision medicine depends on pathologists" Thus, in the immunotherapy of cancer, all determine the mutation of the tumor? Why is there not a single word about the patient's immune system ?! It is she who determines the success or failure of therapy. Success will be where the immune system has a balance of lymphocytes. Active CD25, CD4, CD8, CD16, CD19, CD45, CD54, CD95 and so on .... Medicine is an exact science and does not tolerate assumptions. For this, patients pay their lives.