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

Robert H. Carlson, MBA

Disclosures

June 27, 2016

In This Article

So Far, Only Safety

Bevacizumab is FDA approved for recurrent glioblastoma, so an oral presentation at ASCO 2016 on combining it with pembrolizumab in the session on CNS trials was indeed an early report on immunotherapy plus standard of care.[2]

"But we only reported on the safety; the efficacy data are still maturing. We hope to have a read on the preliminary efficacy in the next 3-6 months," said lead author David Reardon, MD, clinical director of the Center for Neuro-Oncology at Dana-Farber Cancer Institute.

Dr Reardon said the aggregate of initial reports on combinations of immunotherapies has produced sufficient interest to move on to other combination treatments, including combinations with standards of care.

One ongoing trial combines the PD-L1 inhibitor durvalumab (medi4736) with radiation and temozolomide, Dr Reardon said. There were no data to present this year, he said, but probably in 2017 the results of some of these combinatorial regimens will be presented.

"And if the results are really compelling, they may indeed steer us away from cytotoxic approaches for patients, but that is certainly quite a way down the road," Dr Reardon said. At the moment, there are no data either way to know whether the addition of chemotherapy may be a positive or detrimental strategy for brain cancer patients.

Low Toxicity Profile Appealing in Combination

The low toxicity profile of the current immunotherapy agents—at least as monotherapies—may make them attractive in combination with chemotherapies.

"The vast majority of side effects with immunotherapy agents are mild and quite manageable," Dr Reardon said. "From that point of view, combining a treatment that has potential side effects with a treatment with low side effects is much more attractive for patients than a combination of chemotherapies where each has significant side effects."

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