immunotherapy combo worked in 25% of asymptomatic and minimally symptomatic patients who progressed after second-generation hormonal therapy

[George71]

Really good news:

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) demonstrated activity in a biomarker-enriched population of patients with metastatic castration-resistant prostate cancer (mCRPC); however, researchers need to refine the toxicity profile, said Sumit K. Subudhi, MD, PhD.

onclive.com/web-exclusives/...

[NPfisherman]

Thanks for posting, George71...another great article...

The Checkmate 650 trial has been getting some press and these initial results bode well for those with mCRPC that have run out of treatment options..., and even better for those with a high TMB--(tumor mutational burden) which had a solid ORR (Overall Response Rate)... Cohort1 had been treated with hormonal therapy and Cohort 2 was treated with taxanes.

Notably, the ORR was 60% for the TMB-high patients in cohort 1 and 50% for these patients in cohort 2. A subset of patients developed undetectable PSA levels that are longer than 1 year in duration.

For the future:

We will also be able to identify resistance mechanisms that will require additional agents to be added to nivolumab plus ipilimumab. One of the things we always have to worry about when adding more agents to any regimen is the toxicity. Sequencing [therapies] will be important.

Like we have discussed in our posts....look for 2 and 3 agent combos to really provide some " big payback" to prostate cancer--still singing James Brown ... Researchers are on the right track... more hope...

All the best,

Fish

[George71 in reply to NPfisherman]

LOL we need some "revenge" -- "payback" -- "I'm mad" -- they made JB MAD LOL

[George71 in reply to George71]

Turn the volume up -- let the neighbors here it

[j-o-h-n in reply to George71]

youtube.com/watch?v=SzlpTRN...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 02/23/2019 1:37 AM EST

[ctarleton]

Other recent reports about this Phase II clinical trial went into more detail on how over 60% of the men in the trial dropped out early due to toxicities, and only between 25%-33% of those who started actually completed all four dosage rounds. Ipilumumab (Yervoy) in particular has a history of some significant potential for adverse events and side effects. In an earlier Phase III study (Dr. Beer and others) reported in Jan 2017 their findings that "Ipi" vs. Placebo did not statistically improve OS in patients with metastatic castration-resistant prostate cancer. Side effects and adverse events were similarly high. Of the 400 men in the "Ipi" arm, 9 died of adverse events attributable to the drug.

ascopubs.org/doi/full/10.12...

On the other hand, for those who have perhaps already run through many other options today, and who may have some tumor biology/mutations that may respond to these types of combo treatments, the potential benefits may outweigh the risks / side effects for certain individuals who are willing to participate in future clinical trials.

[Teddysdad]

I was on the Neptunes trial in the UK.

I only survived 3 cycles of ipi and nivo due to toxicity issues.

I continued with the nivo for 4 more cycles until a bone scan detected 4 new lesions on my bones.

I am now on my second series of chemo.

[NPfisherman in reply to Teddysdad]

Thank you for participating in a trial...it takes courage and a desire to help others..

Fish