Sharing our research on the global stage at 2021 ASCO Annual Meeting
7 June 2021
Research from MIA was once again in the spotlight as findings were shared at the virtual ASCO21 - the world’s largest professional oncology meeting.
In addition to the recent story revealing the success of a new immunotherapy trial for melanoma, another 14 abstracts involving our researchers were shared at the conference on the weekend. Here is a snapshot of just a few findings:
Managing immune-related side effects
Treatment of melanoma with immunotherapy can be lifesaving; however, it can also be complicated by significant side effects as the activated immune system cells may attack healthy cells as well. Most of the side effects occur in the skin, liver, bowel, thyroid gland and lungs, though any organ can be affected.
Immune cells communicate by producing small proteins, called ‘cytokines’, which co-ordinate the body’s response against inflammation. Sometimes this response can go into overdrive, resulting in increased levels of cytokines, making the inflammation worse.
Medical Oncologist Dr Florentia Dimitriou and colleagues identified a cytokine, known as IL-6, which is increased in many inflammatory conditions, including viral infections, like COVID-19, and rheumatoid diseases, such as rheumatoid arthritis.
“We used a specific drug that blocks IL-6, known as tocilizumab, and found the drug reduced the inflammation and lessened the symptoms in these patients,” said Dr Dimitriou. “Based on this observation, the drug we used specifically blocks the activated cytokines and controls the inflammation, without suppressing the immune system.”
Management of Stage III/IV melanoma with immunotherapy after surgery
Immunotherapy after surgery for Stage III melanoma has become the standard treatment approach. Research from Clinical Nurse Consultant Rebecca Johnson and colleagues aimed to understand who is being treated with immunotherapy across Australia, how effective the treatment was, and the variety of treatment options that are implemented if the melanoma recurs.
“Overall, we found the efficacy of treatment was similar to the clinical trials,” said Ms Johnson. “For most patients with melanoma recurrence, there was evidence of disease in distant organs within two years of recurrence. Across the study, these patients were treated with a variety of treatment options.”
Progression on combination immunotherapy
Research from MIA’s Medical Oncologist Dr Ines Silva and her team focussed on patients whose disease progressed after first being treated with combination immunotherapy - drugs that stimulate immune cells to fight cancer. Although around half of these patients are still alive five years after starting treatment, the majority of patients will progress and may require further treatment.
“We looked at how patients’ disease progressed from first-line treatment with a combination of anti-PD1 therapy and ipilimumab, and then determined management strategies for these patients,” said Dr Silva.
“We have shown that in a group of patients, therapy that targets BRAF mutant melanoma, rechallenged with anti-PD1 alone or in combination with ipilimumab and investigational drugs (in clinical trials), showed activity in this setting, and can be considered a treatment option in this context; chemotherapy has no role in these patients.”
Understanding the importance of radiotherapy after surgery in the modern era of immunotherapy
When melanoma spreads from the skin to nearby lymph nodes, the chances of melanoma coming back after it is surgically removed can be quite high for some patients. In this situation, radiotherapy can be given after surgery to the nearby lymph node area to reduce the chance of melanoma returning.
In an era where immunotherapy is now often given to reduce recurrence after surgery, Medical Oncologist Dr Prachi Bhave and colleagues at MIA investigated whether adjuvant radiotherapy is still effective in reducing melanoma recurrence. The study found that radiotherapy significantly reduced the risk of melanoma returning in nearby lymph nodes, and therefore continues to have a role in some patients whose melanoma has returned despite receiving immunotherapy after surgery.
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