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VIDEO: Following success of immune therapies in GU cancers, focus shifts to understanding non-responders
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Elizabeth R. Plimack, MD, MS, associate professor of medical oncology and director of genitourinary clinical research, Fox Chase Cancer Center, Philadelphia, offers insight on the emergence and evolution of immunotherapy within the subspecialty.
“It’s definitely a new paradigm in terms of treatment,” she said. “Immunotherapy has really revolutionized how we look at kidney cancer and more increasingly bladder cancer.”
Against a backdrop of knowledge gained over the past several years into PD-1 checkpoint inhibitors and anti-CTLA4 antibodies, Plimack discusses the benefits and challenges of managing patients with the agents.
She describes the durable responses witnessed in certain populations who “tremendously benefit” but says the field is now focusing on those who do not or those who experience auto-immune complications.
“We really need to investigate why that is and perhaps introduce ways of shifting patients who don’t respond into the category of responders — or at least those who obtain benefit.”
She details approaches under investigation, touching on a phase 3 trial exploring the combination of ipilimumab (Yervoy, Bristol-Myers Squibb) and nivolumab (Opdivo, Bristol-Myers Squibb) vs. sunitinib (Sutent, Pfizer) as a first-line therapy in renal cell carcinoma.
Plimack also outlines several strategies currently being considered to untangle the questions surrounding biomarkers, including staining for PD-1 in tumor and immune cells and gene expression profiling.
“It’s a really exciting new frontier,” she said. “This may well be able to help us be more rational in our selection of treatment for patients.”