Tumor Agnostic Immune Checkpoint Inhibitors

Exploring a new era of cancer research at this year’s ASCO event

May 23, 2018
Forrest Anthony
Forrest Anthony, MD, PhD
Key Highlights
Our experts weigh in on some of the important topics and trends they anticipate to see this year at ASCO 2018 in Chicago. 

In the final of a series of blogs, Dr. Luis Mendoza and Dr. Forrest Anthony, both members of IQVIA's Therapeutic Science and Strategy Unit, discuss why immune checkpoint inhibitors are transforming cancer care.
 

Every year, oncology experts from across the globe come together at the American Society of Clinical Oncology’s (ASCO) annual meeting to share their latest developments in oncology research and discuss the next generation of therapeutic innovation. Over the past several years, many of these conversations and sessions have focused on advances in immuno-oncology – and immune checkpoint inhibitors (ICIs).

Immunotherapies, including immune checkpoint inhibitors are transforming cancer care. Instead of stimulating the immune system directly, ICIs block the brakes that tumors apply to the immune system so that immune system cells can continue to attack and kill cancer cells.  This medical innovation has delivered unprecedented value in the successful treatment of cancer patients, even where other treatments have failed. In its 2018 annual report, ASCO estimates that immune checkpoint inhibitors would “save 250,000 years of life if all US patients with advanced lung cancer for whom ICIs are currently indicated receive the treatment.” It also states that one in four newly diagnosed cancer patients, and one in 10 patients with previously treated disease, may live well beyond five years after treatment initiation thanks to ICIs.

The U.S. Food and Drug Administration (FDA) has already approved several immune checkpoint inhibitors to address nine different cancers, with several more in development. Among the most notable are two accelerated approvals granted last years for ICIs addressing microsatellite instability-high (MSI-H) colorectal and non-colorectal tumors.  Pembrolizumab was approved for the treatment of adult and children with unresectable or metastatic MSI-high or DNA mismatch repair deficient (dMMR) solid tumors; and nivolumab was approved for the treatment of patients 12 and older with dMMR and MSI-H metastatic colorectal cancer that has progressed following treatment.

The success of these two drugs is significant because they are the first ICIs approved on the basis of the genetic make-up of the tumor, rather than the specific tumor type or location. In other words, these indications are tumor-agnostic (also termed tissue-agnostic or site-agnostic) These advances in ICIs to treat MSI-H tumors are particularly notable because these tumors can have thousands of mutations and represent a significant percentage (10-30%) across a significant fraction of tumors. One of the studies for pembrolizumab included patients with 12 different tumor types using the same treatment, and 21% of those patients went into complete remission.

To date, pembrolizumab and nivolumab are the only two drugs to receive approvals based on a tumor’s biomarker status without regard to the tumor’s original tissue type or location. While these drugs are groundbreaking on their own, they also represent an exciting shift in the way oncology treatments can be developed, tested, and used to create opportunities for a single treatment to address multiple kinds of cancer. These approvals underscore the exciting advances being made in the arena of ICIs, and herald a new generation of oncology treatment based on tumor signature rather than tumor type. 

Let’s Connect at ASCO

We recently coauthored a white paper for IQVIA clients and clinical staff on how ICI tumor agnostic treatment approvals represent a promising new direction for oncology care. We and IQVIA experts are also looking forward to the ASCO meeting June 1-5 in Chicago, to discuss these and other oncology trends with peers from across the industry and to learn about innovations in oncology.

We know several speakers at the event will focus on trends in ICIs, including Dr. Gavin Dunn from the Washington University School of Medicine, who is giving an update on Checkpoint Inhibitors and Combinatorial Approach to Targeted Immunotherapies; and Dr. Jennifer Ann Wargo, from the University of Texas MD Anderson Cancer Center who will present on Novel Checkpoint/Targeted Therapy Combinations. We will also hear about some of the risks related to ICIs, including a presentation on Immune-Checkpoint Toxicity from Dr. Marc Ernstoff, of the Cleveland Clinic; and an education session on Primary and Acquired Resistance to ICIs.

The opportunity to hear these kinds of presentations and to talk with experts who’ve dedicated their careers to advancing oncology care is why ASCO is one of the most important events of the year. Researchers spend most of their time with their heads down, pursuing new treatment innovations, but oncology innovations don’t happen in a vacuum. By taking the time to come together at ASCO and other industry events we can share our successes, find new collaborations, and help drive innovation on behalf of all patients while ensuring the safety and efficacy of the trials we lead and the treatments that come to market. We look forward to seeing you there.

 

More about our contributors

Forrest H. Anthony, MD, PhD

Forrest H. Anthony, MD, PhD, is Senior Director IQVIA Oncology Center of Excellence, North America. Dr. Anthony has more than 25 years’ experience in the biopharmaceutical industry. He works on customer drug development projects, and trains global staff to anticipate scientific innovations (e.g., immuno-oncology, Adoptive Cell Therapy, CAR-T therapies, oncolytic viruses). 

 
Luis Mendoza, MD, PhD

Luis Mendoza, MD, PhD, is Senior Medical Director of IQVIA’s Oncology-Hematology Therapeutic Science & Strategy Unit. Dr Mendoza joined IQVIA in 2015 after 20 years in the oncology medical practice combined with 12 years of experience in clinical development of different oncology compounds. Besides his clinical research experience with different anticancer monoclonal antibodies, immunomodulatory drugs, bi-specific monoclonal antibodies, oncolytic virus vaccines, cellular therapies etc and he has been focused leading clinical trials for novel checkpoint inhibitors and novel immunotherapies. Dr Mendoza is editorial board member of oncology-hematology journals and author of dozens of publications in peer-reviewed journals.

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