This episode comes from ASCO 2016 in Chicago, the annual meeting of the American Society of Clinical Oncology. In it, you’ll hear experts such as Dr Johanna Bendell, Dr Jérôme Galon, and Dr Stephen Liu talk about some of the latest cancer immunotherapy data.
One of the ASCO presentations featured in this podcast episode was by Dr Jérôme Galon (INSERM), who presented the results of a global clinical trial that validated Immunoscore as a prognostic marker in Stage I/II/III colon cancer (ASCO 2016 abstract #3500).
Dr Galon is an immunologist, who has pioneered a way of quantifying the immune response in colon cancer, then correlating that with patient outcomes. Two pioneering papers were published over a decade ago in Science and The New England Journal of Medicine that paved the way for development of Immunoscore:
Thanks to support from the Society for Immunotherapy of Cancer (SITC), a worldwide consortium of 21 centers in 15 countries enrolled more than 3,500 colon cancer patients to validate Immunoscore as new approach for the classification of the disease.
The results showed that Immunoscore predicts time to recurrence (TTR), disease free survival (DFS), and overall survival (OS). Using the immune response as an alternative way to stage the cancer allows high-risk patients to be identified early. This is the first standardised immune-based assay for the classification of cancer.
The significance of this global trial merited at a plenary presentation at ASCO. What’s more, new research published earlier this year from the Galon lab in the journal, Immunity, showed that Immunoscore is valid as a prognostic marker, irrespective of microsatellite stability (MSS) or instability (MSI):
The ASCO interview with Dr Galon featured on the podcast followed an interview he kindly gave at the European Cancer Congress 2015 in Vienna last year, where he talked in more detail about Immunoscore and his research.
Both interviews were first published on Biotech Strategy Blog (subscription required):
- Immunosurveillance, Immunoscore & Personalized Cancer Immunotherapy
- Immunoscore validated as an important biomarker for colon cancer
Update 7 July 2016: Immunoscore is being commercialised by HalioDx (@HalioDX). In a July 7 press release they announced:
“Immunoscore® Colon, the first standardized immune-based assay for the classification of cancer, will be available in July 2016 through HalioDx service laboratory*.
By the end of the year, pathologists will have access to a CE-IVD assay in Europe, while a RUO (Research Use Only) solution will also be available in the rest of the World.
* This test is intended for Research Use Only. Not for use in diagnostic procedures.”
You can find more information on the Immunoscore-Colon website.
Cancer Immunotherapy in MSS Colorectal Cancer
Another ASCO 2016 presentation featured on the podcast was by Dr Johanna Bendell who presented some early data for the combination of a MEK inhibitor (cobimetinib) with a PD-L1 checkpoint inhibitor (atezolizumab) in patients with microsatellite stable colon cancer (ASCO 2016 abstract 3502).
As you’ll hear on the podcast, it’s really exciting to see the potential of the combination of a targeted therapy and a cancer immunotherapy turning to generate responses in colon cancer patients with microsatellite stable disease (MSS), a population of patients that have not responded to checkpoint monotherapy.
The message from ASCO 2016 for patients with colon cancer was very much one of “hope.”
A global phase 3 clinical trial with the cobimetinib/atezolizumab combination in chemo-refractory CRC has been announced.
If you are a patient with advanced CRC interested in participating in a cancer immunotherapy clinical trial, do talk to your doctor to see if this study is something you should consider. The locations of the 42 study centers are listed on clinicaltrials.gov (NCT02788279).
2018 Update: It was disappointing that despite the scientific promise and the hope behind this trial, it did not end up being a positive one as Roche/Genentech announced in a May 2018 press release (link).
In April 2019 the results were published in The Lancet Oncology, “Atezolizumab with or without cobimetinib versus regorafenib in previously treated metastatic colorectal cancer (IMblaze370): a multicentre, open-label, phase 3, randomised, controlled trial.”
As the authors poignantly conclude: “These results underscore the challenge of expanding the benefit of immunotherapy to patients whose tumours have lower baseline levels of immune inflammation, such as those with microsatellite-stable metastatic colorectal cancer.”
Immunotherapy Combinations may change Lung Cancer Standard of Care
Dr Stephen Liu (Georgetown) is actively involved in lung cancer immunotherapy trials, and on the latest podcast episode, he discusses several presentations that caught his attention at the meeting.
Some of the combination trials he highlighted on the show include:
- OX40 agonist & PD-L1 checkpoint inhibitor (ASCO 2016 abstract #101)
- 4-1BB agonist & PD-1 checkpoint inhibitor (ASCO 2016 abstract #3002)
- PD-1 checkpoint & radiotherapy (ASCO 2016 abstract #3024)
- Two checkpoints together (ASCO 2016 abstract #3001)
Dr Liu also offers his clinical perspective on a presentation by the FDA (ASCO 2016 abstract #3000), which looked at the effectiveness of treating beyond progression with PD-1 checkpoints in lung cancer.
The interviews with Dr Galon, Dr Bendell and Dr Liu were first published on Biotech Strategy Blog (subscription required).
Patient advocacy organisations such as Fight Colorectal Cancer (Fight CRC) offer a wealth of information and resources. Fight CRC are particularly active in lobbying Congress and generating awareness about the importance of early screening.
Dr Tom Marsilje (@CurrentIncurSci) has stage IV colorectal cancer. He writes a blog (Adventures in Living Terminally Optimistic) and a monthly science column, “Currently Incurable Scientist.” Do follow Tom’s science commentary.
2017 Update: As a scientist, Tom after his CRC diagnosis, was on a quest to find an effective treatment for his disease, but it was a race against time. On November 14, 2017 he sadly passed away at age 45 (link to STAT story).
Tom’s advocacy efforts live on through the Colontown patient support community where he helped others navigate clinical trials and identify options based on the emerging science and their disease biology.
This podcast episode was produced thanks to sponsorship from Genentech.
The podcast is editorially independent which means that apart from their “vignette,” sponsors have no control over who we interview, the topics we cover, or the questions we ask.
The music in this podcast episode is by electric violinist and composer David Schulman from his album Quiet Life Motel.
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