ASCO-SITC Clinical Immuno-Oncology Symposium


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Immunotherapy in NSCLC: Forging an Immunologic Oasis Within an Immune Desert Sandip Patel, MD I mmune checkpoint blockade has revolutionized cancer therapy, including solid tumor types that historically have not been con- sidered immune sensitive. Although melanoma and renal cell carcinoma are traditionally thought to be responsive to immu- notherapy based on long-term survival in a subset of metastatic patients treated with interleukin-2, non–small cell lung cancer (NSCLC) had historically not been amenable to immunotherapeu- tic approaches. However, with the advent of immune checkpoint blockade, robust evidence suggests that anti–PD-1/PD-L1 targeting therapy is effective in advanced NSCLC. With novel immunothera- peutic combinations on the horizon, medical oncologists have used increasingly effective tools to treat patients who suffer from the most common metastatic cancer worldwide. Immunobiology The current generation of anti–PD-1/PD-L1 directed antibodies effectively function as immunologic prodrugs. This therapeutic class (nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab) works by disrupting the inhibitory PD-1/PD-L1 binding axis, ideally reinvigorating tumor-specific T cells with- in the tumor microenvironment or within the tumor-draining lymph node. 1 These activated T cells themselves are the actual cancer-fighting therapeutic. Thus, for immune checkpoint block- ade to be effective, the patient requires a specific, pre-existing T-cell response against tumor, often associated with a peritumoral immune infiltrate driven by interferon gamma, in which the pre- dominant mechanism of T-cell exhaustion is related to the PD-1/ PD-L1 interaction. From a predictive biomarker standpoint, overexpression of PD-L1 Dr. Jeffrey A. Bluestone Tracks Immunotherapy's Path to Precision J effrey A. Bluestone, PhD, president and CEO of the Parker Institute for Can- cer Immunotherapy, will provide an overview of past de- velopments in cancer immuno- therapy and discuss the future of research in this field in his keynote lecture on January 25. Dr. Bluestone joined the Park- er Institute, a nationwide cancer research initiative funded by The Parker Foundation, in 2015. He is recognized as one of the lead- ing experts in the field of immu- notherapy—his work in the mid- 1990s led to the development and approval of the first CTLA-4 antagonists for the treatment of metastatic melanoma and laid the foundation for development of other immune checkpoint in- hibitors for cancer treatment. In an interview with the ASCO-SITC Clinical Immuno-On- cology Symposium Daily News, Dr. Bluestone discussed important discoveries in cancer immuno- therapy and latest research at the Parker Institute. Q: What are your goals as CEO and president of the Parker Institute? Dr. Bluestone: At Parker, we have brought together the lead- ing scientists, doctors, and in- dustry partners in the field, and forged a model that encourages true collaboration. Our ulti- mate goal is to accelerate the development of innovative im- mune therapies that can cure cancer. My main role at Parker is to establish an environment and infrastructure that makes this possible. Part of that is working with the best investi- gators and institutions to build seamless partnerships that en- able big ideas and breakthrough discoveries. To that end, we recently wel- comed some very important partners to the Parker fold—the Dana-Farber Cancer Institute and Phil Greenberg, MD, of Fred Hutchinson Cancer Re- search Center, who joined our six initial founding institu- tions: Memorial Sloan Kettering Cancer Center; Stanford Medi- cine; the University of Califor- nia, Los Angeles; the University of California, San Francisco; the University of Pennsylvania; and The University of Texas MD An- derson Cancer Center. Q: What is the current focus of research conducted at the Parker Institute? Dr. Bluestone: Parker has four main strategic areas of research and a number of core technol- ogy initiatives. We are building next-generation T-cell therapies for more targeted, safe, and long-lasting treatment. We also are investigating checkpoint inhibitor resistance to uncover why some patients respond to immunotherapy whereas others do not. In this area, we include a recent focus on the microbiome and its role in checkpoint inhibitor thera- peutic success. Our tumor-anti- gen discovery research program is focused on predicting and validating neoantigens, which are an important element in developing personalized treat- ments such as therapeutic can- cer vaccines. We also seek to better understand the tumor microenvironment, which we think will be key to creating immune therapies effective for solid tumors, which, so far, have been difficult to treat. Finally, in addition to these strategic areas for therapeutic intervention, we have initi- ated an important program in autoimmunity and cancer—a collaborative effort to deter- Immunotherapy for Metastatic Bladder Cancer I n the following article, Emily Lemke, DNP, APRN, and Ami- shi Shah, MD, both of The University of Texas MD An- derson Cancer Center, answer a question from an attendee dur- ing a Best of ASCO ® Meeting. Question: What is your preferred immunotherapy for bladder cancer and why: pembrolizumab, atezolizumab, or nivolumab? Answer: The advent of im- mune checkpoint inhibitors has caused a paradigm shift across treatment of many different malignancies, including urothe- lial carcinoma. For the first time since the 1980s, checkpoint blockade has emerged as a new and exciting therapy for patients with metastatic urothelial carci- See Immunotherapy in NSCLC, Page 3 Why I Attend: International Oncologist's Perspective 4 SITC Scientific Resources 4 Symposium Essentials 4, 12, 15 Precision Immunotherapy for Rare Tumors 6 Poster Session Tips 8 Join SITC 9 Immunotherapy for Merkel Cell Carcinoma 10 Immunotherapy Promising in Gynecologic Cancers 13 Fellows Day Workshop 14 Future of Immunotherapy in Pancreatic Cancer Treatment 14 Attend Ancillary Events 15 Dr. Jeffrey A. Bluestone See Metastatic Bladder Cancer, Page 6 Clinical Corner INSIDE See Dr. Bluestone, Page 3 Attendee Tip of the Day Use Interact, powered by Touch, to: ➤ View speaker slides on your personal device in real time ➤ Take notes on slides during sessions ➤ Pose questions to session faculty ➤ Use audience response technology ASCO-SITC Clinical Immuno-Oncology Symposium 2 0 1 8 daily news T H U R S DAY, JA N UA RY 2 5 • S A N F R A N C I S C O

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