Promising data for advanced melanoma patients

Promising data for advanced melanoma patients

9 October 2019

Melanoma Institute Australia (MIA) has presented promising data regarding progression-free survival rates for advanced melanoma patients at the European Society for Medical Oncology (ESMO) 2019 Congress in Barcelona.

Follow-up data from the ground-breaking ABC (Anti-PD1 Brain Collaboration) trial was presented by MIA Co-Medical Director Professor Georgina Long.  This trial is a phase II randomised trial involving melanoma patients with untreated brain metastases receiving either a combination of nivolumab and ipilimumab or nivolumab alone –In patients who received the combination therapy, 43% had no disease progression in their brain after three years. The 3-year rate for no progression of metastases in the brain increased to 48% if patients had no prior therapy. These 3-year rates indicate the ongoing durability of intracranial response from immunotherapy, and that the response is likely to continue long-term for almost half of all patients.

The overall survival rate at 3 years on the combination treatment was 49%, on single therapy was 42%, and a final cohort – those patients who would usually have been excluded from clinical trials because of the severity of their brain metastases – was 19%, which is a significant increase in life expectancy for these patients.

Five-year survival rates from the longest-running phase III trial of combination immunotherapy in melanoma patients were also presented at ESMO. The overall survival for those patients on combination ipilimumab and nivolumab was 52%, with 36% of patients progression-free.

Also on display at ESMO were four posters from our researchers. Post-doctoral researcher Dr. Ines da Silva presented our findings on the overall survival of melanoma patients based on the pattern of their metastases, and was awarded the best poster presentation at ESMO. She found that patients with brain metastases and liver metastases lived for shorter periods than patients without melanoma in these sites. She also found that different metastatic sites were asociated with different patterns of further metastasis, indicating that patterns of metastasis may be another helpful factor in determining prognosis.

Medical oncology Fellow Dr. Adriana Hepner presented data on the efficacy and safety of immunotherapy treatment after a patient has become resistant to combination immunotherapy. She found that giving patients immunotherapy again after they have already become resistant benefited a small subset of patients, although patients may have a recurrence of previous toxicities. This poster highlighted the need for further research into new and different treatments for these patients.

Medical oncologist and MIA PhD student Dr. Kazi Nahar's, presented her work on the characteristics of one of the major immune-related toxicities caused by immunotherapy treatment – colitis, or inflammation of the inner lining of the colon. She found that combination immunotherapy - while being highly effective for many melanoma patients - was more likely to cause earlier onset and more severe colitis in melanoma patients that also seems to be more resistant to steroid treatment.

Finally, PhD student Hansol Lee presented a poster that discussed the role of a type of immune cell called macrophages, on response to combination immunotherapy. He found that patients who responded to treatment had more macrophages within their tumour before they began treatment, and a higher amount of a particular subset of macrophages is associated with a significantly better overall response and progression-free survival rate.

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