A single-patient study at the Fred Hutchinson Cancer Research Center found that combining ipilimumab and interleukin-21 (IL-21) in metastatic melanoma eradicated the tumors and the patient remained disease-free 5 years post treatment.
A single-patient study at the Fred Hutchinson Cancer Research Center could be the foundation for a clinical trial to evaluate the combination of a CTLA-4 inhibitor, ipilimumab, and interleukin-21 (IL-21) in metastatic melanoma. The treatment eradicated the tumors and the patient was reported disease-free 5 years post treatment, in a paper published in The Journal of Experimental Medicine.
Patients diagnosed with melanoma, who are refractory to treatment, are the most difficult to treat. Additionally, with immunotherapy agents, the complications associated with the phenomenon of “pseudo-progression” make treatment tricky. As John A. Thompson, MD, a coauthor on the current paper, emphasized at the annual meeting of the National Comprehensive Cancer Network in March this year, healthcare providers need to be aware of this effect when treating patients with immune checkpoint inhibitors.
In the current report, clinicians at the Fred Hutch Cancer Research Center infused a 53-year-old patient with his own antitumor T-cells, which had been stimulated with the immune response stimulator IL-21, followed by a dose of ipilimumab. The patient’s disease had previously failed to respond to either treatment alone. However, within weeks of the combination treatment, the patient’s tumors began to shrink and then completely disappeared. The most encouraging part is that the patient remains in remission at the 5-year mark post treatment.
The authors write that long-term persistence and sustained anti-tumor activity of transferred cytotoxic T-lymphocytes, as well as responses to nontargeted antigens, resulted in mutually beneficial effects of the combination. Combining adoptive cellular therapy with CTLA4 blockade provided sufficient boost to the patient’s immune system to induce long-term remission, compared with both modalities administered serially or individually.
“Combining CTLA4 blockade with the transfer of well-characterized, robust antitumor T cells represents an encouraging strategy to enhance the activity of the adoptively transferred T cells and induce antitumor responses,” Cassian Yee, MD, senior author on the paper said in a statement. Yee now works at The University of Texas MD Anderson Cancer Center in Houston. “This strategy may hold broad promise for ipilimumab-resistant melanomas.”
Reference
Chapius AG, Lee SM, Thompson JA, et al. Combined IL-21—primed polyclonal CTL plus CTLA4 blockade controls refractory metastatic melanoma in a patient [published online, May 30, 2016]. J Exp Med. doi:10.1084/jem.20152021.
Lack of Mutations Associated With Favorable Prognosis in MPN-U
April 25th 2024While the Dynamic International Prognostic Scoring System and bone marrow blasts may predict overall survival, the lack of certain mutations is also associated with a better prognosis for myeloproliferative neoplasm, unclassifiable (MPN-U).
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
HOPE-CAT Can Identify Maternal Cardiovascular Risk 2 Months Earlier Than Doctors, Study Says
April 25th 2024In a retrospective study, the machine learning tool was able to screen for potential risks of cardiovascular disease nearly 60 days before the patient's medical record showed any signs of a related condition or before they were officially diagnosed or treated for it.
Read More
Data Back Neoadjuvant Combo vs Chemo Alone for Early-Stage NSCLC
April 24th 2024For patients with early-stage non–small cell lung cancer (NSCLC), combining neoadjuvant immune checkpoint inhibitors and platinum-based chemotherapy improves 2-year outcomes over chemotherapy alone, suggest findings of an extensive literature review and meta-analysis.
Read More