Immunotherapy 'Plus': Adding Radiation and Chemo to Immune Therapies

Robert H. Carlson, MBA

Disclosures

June 27, 2016

In This Article

Synergy With Chemotherapy

Dr Wolchok said that there are intriguing hints of synergy between chemotherapy and immunotherapy as well.

"Traditional chemotherapies have typically not had a very high level of efficacy in metastatic melanoma, but there have been anecdotal observations of patients who had progressed on immunotherapy and were given one or two cycles of chemotherapy and then had dramatic responses."

Whether those effects need to be achieved by concurrent combination or by a sequenced approach is an important, open question, he said.

Could immunotherapy ever supplant chemotherapy? Dr Wolchok could not speculate on that.

"But it is no surprise that we are using less chemotherapy in melanoma in 2016 than we did, say, in 2010. The significant advances in both targeted and immunotherapy are simply more effective than cytotoxic chemotherapy."

Dr Bernicker said the jury is out regarding whether patients with lung cancer should be treated with chemo-immunotherapy.

He said there are large national randomized trials in lung cancer that are assigning patients to standard front-line therapy or chemotherapy plus immunotherapy.

"Hopefully we'll be smart enough to develop a biomarker or a series of biomarkers that tells us who needs to be treated up front with immunotherapy by itself, or who needs chemo," Bernicker said.

The biomarker most in use now is PD-L1, "which none of us thinks is a good biomarker," he added.

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