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Good News Article
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Good News Article

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      • February 27, 2019 at 10:54 pm
      ed williams
      Participant

        Hi Brian, these new neoadjuvant trials are really interesting, and this one is published in Nature Medicine but my budget doesn't allow for me to buy these articles when they come out, but I am sure by ASCO in June the findings will be published. In the article abstract in nature they give some data, with 8 out of 27 patients showing early response. I would love to see all the data but if my math is accurate 8 dividing by 27 = 29% well below the 40% reponse rate in patient who have taken Pd-1 drugs at stage 4 after 4 years of data from keynote 006 and checkmate 067. I think part of the research is trying to get at a biomarkers to see who will respond and who will progress, but without the full article it is hard to tell. Here is link to abstract, again sorry it isn't the whole article just a tease!!!! https://www.nature.com/articles/s41591-019-0357-y

          • February 28, 2019 at 1:28 am
          Brian j
          Participant

            Ed,

            Just passing on some good news, seems to be significant. Here is some more Data. interesting to note the 8 people had 100% response. Is the 40% response rate you use people that are 100% DFS?

            "On histologic assessment, 8 of 27 patients (29.6%; 95% confidence interval, 13.8–50.2%) had a complete (no residual tumor identified; n = 5)" There are several major findings. First, we observed a rapid immune response after PD-1 blockade with T cell reinvigoration peaking 7 days post treatment initiation and complete or major pathologic response in 30% of patients within 3 weeks. Notably, these patients with early complete or major pathological tumor response have 100% DFS at 24 months. In contrast, patients without robust pathological responses at surgery had a poor prognosis with greater than 50% risk of recurrence despite adjuvant therapy. A neoadjuvant approach might allow for early identification of high-risk patients and a change to more effective adjuvant therapy. Second, the data from TILs pre- and post-treatment support a role for CD8 T cells with characteristics of TEX. Finally, these studies provide evidence for mechanisms of response and adaptive resistance including immune failure, immune regulation, and immune escape.

            • February 28, 2019 at 4:02 am
            ed williams
            Participant

              What does the article say about stage of the patients before surgery? Are they early stage 3 patients that are having neoadjuvant therapy before lymph node resection or are the patients stage 4 with lung mets??? Have you been able to read the whole article in Nature magazine? My understanding of the neoadjuvant research that is going on was they were giving immunotherapy before the surgery for stage 3 patients so when they respected the tumor a few weeks later they would be able to see what happens in the micro environment of the tumor.

            • February 28, 2019 at 1:27 am
            Bubbles
            Participant

              Neoadjuvant studies using both targeted therapy (BRAF/MEK combo's) as well as immunotherapy (ipi, nivo, pembro, and ipi/nivo) are all very interesting.  Here is a link to multiple reports:  https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=neoadjuvant  

              Like Ed notes, I'm sure much more will be reported out on these studies in June at ASCO.  Thanks for sharing.  Celeste

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