Pooled data of nearly 2000 patients across six trials in melanoma using IO therapy. It seems clear that high dose corticosteroid use was associated with worse outcomes, especially with high peak doses. What may be worth considering is if non-steroid based immunosuppression can be used as an adjunct to blunt this concerning effect.
I love this trial in that it advances science but also balances cost. Neoadjuvant therapy with ipilimumab + nivolumab (Ipi+Nivo) x 2 followed by surgery followed by adjuvant nivolumab. Patients with a major pathologic response went on to observation alone. Again, intact tumor-immune interactions are key to maximum treatment effectiveness. Another key to these patients is seeing a medical oncologist before surgery.
Preoperative chemoradiation added to perioperative chemotherapy (ECF/ECX or FLOT) was not beneficial. Of note this study was done in a non-US, predominantly caucasian population. It seems XRT has less and less of a role in gastroesophageal junction / gastroesophageal (GEJ/GE) cancers.
Small testing size, but still with high overall response rate (32%) with progression-free survival of 5.6 months. Now, this is not randomized and is after failure of check point inhibitors. Of note this medication will not be marketed for second line therapy since it did not show overall survival advantage.
Improved outcome in patients with brain metastases, but only uses a small number. It is still promising.
Adding SBRT improves local control and disease progression in the brain but not overall survival. Do the radiation oncologists have input? Is it worth it to control symptoms?
Superior to osi (23 vs 16 progression-free survival). This is more toxic though, but seems manageable. Could this be a new first line standard of care? Also, this includes brain penetration data.
Less radiation is non-inferior, this is for low and intermediate-risk localized prostate cancer patients. Would like input from our radiation oncologists as to whether or not this adoptable?
This is not only safer (less toxicity with nivo) but reduced disease progression or death by 52%.
Impressive improvement in overall survival when comparing 55 vs 33 months and progression-free survival (almost double) due to tolerable toxicity. Now in NCCN guidelines…