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5.9 AACR
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Today
at the AACR Annual Meeting 2015, researchers presented new data on the
PD-1 inhibitor pembrolizumab (Keytruda) that have the potential to lead
to further changes in clinical practice.
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5.9.2 AACR - hémato
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More
than 60 percent of patients with Epstein-Barr virus–associated
lymphoproliferative disorder (EBV-LPD) that was not responding to
standard rituximab (Rituxan) treatment responded to a new type of
immunotherapy called Epstein-Barr virus–specific cytotoxic T lymphocyte
(EBV-CTL) therapy, according to data from two clinical trials.
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5.9.3 AACR - mélanome
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“Immunotherapy
is not just a single agent or class of agents; there are many
targetable molecules to manipulate many facets of the immune responses
against cancer. Checkpoint inhibition was just the beginning.”
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“Our
goal with the KEYTRUDA development program is to help improve long-term
disease control and survival for people suffering from a wide range of
cancers,” said Dr. Roger Perlmutter, president, Merck Research
Laboratories.
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"One
can think of IMCgp100 as a molecular bridge connecting melanoma cells
with killer T cells, encouraging the killer T cells to destroy the
melanoma cells."
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The
lead investigator of this trial, Caroline Robert, MD, PhD, head of the
Dermatology Unit at the Institut Gustave-Roussy in Paris, France, said,
“As of today, pembrolizumab is still not on the market in Europe, except
in the context of an expanded access program after failure of
ipilimumab."
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IMCgp100 shows partial and complete durable responses in Phase I/IIa trial in patients with advanced melanoma.
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“I
think we are watching a revolutionary change in cancer therapy,” says
Roger Perlmutter, Merck’s head of research and development. “Certainly
the most important advance in my lifetime and maybe the most important
advance since the introduction of radiotherapy.”
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One
year after the start of treatment, 74% of patients who received
Keytruda every two weeks and 68% of those who received it every three
weeks were still alive, compared with 58% for those who received Yervoy.
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5.9.4 AACR - poumon
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The
efficacy findings demonstrated that tumor PD-L1 expression may be a
relevant biomarker for the identification of NSCLC patients with an
enhanced likelihood of experiencing improved efficacy with an anti-PD-1
therapy.
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“Neither
the drug nor the biomarker test is approved for use in this setting at
this time, but if I had a patient whose tumor had PD-L1 expression on at
least half of the cells and if pembrolizumab was available, I think
that I would find the data compelling to look at the drug as the
treatment option for that patient,” Garon said.
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Researchers
said about a quarter of trial patients had PD-L1 expression in at least
half of their tumor cells. Overall, 19 percent of trial patients
responded to the drug.
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5.9.5 AACR - CAR-T
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“Our
long-term goal is to develop a new generation of CART-meso cells that
can persist in the patients for years so that, besides eliminating
cancer cells, they could also prevent recurrence of the disease.”
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The
new immunotherapy, known as CART-meso (short for mesothelin), was
administered to five patients with advanced cancers no longer responding
to multiple lines of prior therapy. Two patients had ovarian cancer,
two had epithelial mesothelioma (a type of lung cancer) and one patient
had pancreatic cancer.
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5.9.6 AACR - divers
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Of
the 10 evaluable patients with ovarian cancer, seven had partial
responses. Of the two evaluable patients with squamous NSCLC in the dose
expansion section of the study, both had partial responses. “An
expansion cohort in squamous lung cancer is currently ongoing to follow
up these encouraging findings,” Banerji said.
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Among
the 40 patients on the trial, three experienced partial responses to
the drug combination. One patient with triple-negative breast cancer had
a partial response that lasted more than 10 months, and two patients,
one with melanoma and one with cancer of unknown primary, had partial
responses that lasted more than 7.5 months.
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“This
presentation at AACR marks the first time that data involving an
anti-PD-1 therapy have been presented in pleural mesothelioma, which is a
rare, hard-to-treat cancer with very limited treatment options.”
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In
this study, Nilsson and colleagues analyzed the efficacy of a
blood-based “liquid biopsy” in assessing the presence in blood platelets
of EML4-ALK in patients with NSCLC.
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In
this prospective study, Cao and colleagues collected data on aspirin
use, cancer diagnoses, and other risk factors from 82,600 women from the
Nurses’ Health Study and 47,651 men from the Health Professionals
Follow-up Study. After 32 years of follow-up, 27,985 incident cancers
were documented.
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Blueprint Medicines also presented data identifying new cancer drug targets during a minisymposium at AACR on cancer genomics.
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“We
don’t have survival data yet, but the 76 percent disease-control rate
that we observed among patients with advanced malignant pleural
mesothelioma who had disease that had progressed after standard therapy
or who were unable to receive standard therapy is very promising."
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