Immunotherapy in melanoma -what other cancers could learn from us

J. Weber on the checkpoint inhibitors in Melanoma -what other cancers could learn from us

Relevant for us and other cancers:

-the pattern of response to immune therapy is generally slow; tumours can regress (shrink) over 6-12 months, responses can be mixed (some tumours respond, others grow) and then followed by regression, tumours can first progress and then regress.

-as the response  to immune therapy looks so different from e.g. chemotherapy, it is now also measured differently by irRECIST;

-if there is progression but the blood tests are ok, further measurements are required as this might not be TRUE progression (pseudoprogression)

- the duration of treatment is in most cases 2 years, but not less than one year- but we need more trials to find out the optimal length of treatment

- most patients with CR (complete response) stayed in remission after stopping treatment (see Caroline Robert's work), but even some with PR (partial response) achieved long term responses

- patients with partial response who progressed subsequently responded to a re-challenge with immunotherapy

- new profiles of toxicity (grade III/IV) need to be recognized as early as possible and managed by regimens of corticotherapy. This needs better training of oncologists and other physicians to make sure patients are treated correctly.

Hundreds of new trials started/will start in other cancers!

The article on J. Weber presentation can be found HERE

Wikipedia on irRECIST

A good explanation about the grading of side effects from the HIV community.