Please login or register first to view this content.
How Recent Adaptations to Clinical Trials Could Help Cancer Research: Innovation at SITC 2020 |
Practice Community
Iowa City, Iowa
Practice Niche
Gastrointestinal Cancers
Hospital and Institutional Affiliations
University of Iowa Health Care
This interview has been condensed and lightly edited for clarity.
Question What were the most compelling data coming out of the Society for Immunotherapy of Cancer 35th Anniversary Annual Meeting & Preconference Programs (SITC 2020), in your view? |
Answer This year, some of the key advances I was looking for out of SITC involved discoveries related to better biomarkers in terms of immune checkpoint inhibitors (ICIs) and other targeted treatments.
|
Question Research out of SITC 2020 showed that neoadjuvant treatment with chemotherapy plus nivolumab resulted in a greater frequency of downstaging in non-small cell lung cancer (NSCLC) compared with chemotherapy or ICI treatment alone.1 What is your view of the use of ICIs in this setting? |
Answer These results are interesting to see, not just for NSCLC, but also for some other tumor types. It used to be that immunotherapy and chemotherapy were considered separate entities, with patients treated with 1 or the other. For many tumor types, including esophageal cancer, data are showing that this may not be the case. These 2 treatments may be complementary.
|
Question There were many plans announced of trials that will begin or are in progress, especially in renal cell carcinoma (such as COSMIC-313), but perhaps most interesting is a study that found that there were racial differences in outcomes for patients with renal cell carcinoma (RCC) who were administered ICIs.2 Should trials in RCC be adjusted to account for these ethnic/racial differences that are found? How can oncologists start to do that? |
Answer It is interesting but not surprising. Immunotherapy drugs directly rely on the patient’s immune system, and we know that not just race, but also sex and other variables, play a role in the metabolism of drugs. From a [trial] design standpoint, it should not be difficult to better incorporate race or ethnicity into clinical trials. The National Institutes of Health mandates that NIH-sponsored trials at these cancer centers include a certain proportion of women and minorities. Additionally, they follow up to see if the proportion planned for enrollment holds up in the actual trials. For example, if the center in practice sees more African Americans for a disease type, but in the trials, the numbers are the opposite — that is a red flag.
|
Question CPI-006, a B-cell activating antibody originally under development as an anticancer therapy, showed early efficacy as a potential treatment for coronavirus disease 2019 (COVID-19).3 Are you surprised to think that a cancer immunotherapy might have utility as a treatment for COVID-19? Why or why not? |
Answer I am not surprised. As we deal with drugs like immunotherapies and targeted therapies, it is not surprising that these may have effects on the SARS-CoV-2 virus or any other infection. One historical example involves lymphoma and HIV. There was always a concern about whether immunotherapy might be a contraindication in patients with lymphoma and HIV, but now there are trials that show that immunotherapy can be incorporated into treatment and may have positive consequences on the person’s infection. Similar things have been shown with hepatitis C and liver cancer.
|
Question Speaking of vaccines, there were many presentations at the meeting on vaccines for cancer (glioblastoma, melanoma, etc.).4,5 What are some strategies in vaccine development that oncology researchers can learn from in the quest for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine? |
Answer The biggest thing to learn relates to the fact that everybody was so invested in this question. Every week there are more developments in the area of SARS-CoV-2 vaccines.
|
References
Please login or register first to view this content.