Nivolumab and Ipilimumab for Metastatic Prostate Cancer with an Immunogenic Signature: Phase 2 Trial

[God_Loves_Me]

(UroToday.com) The 2024 American Society of Clinical Oncology (ASCO) annual meeting held in Chicago, IL between May 31 and June 4 was host to the Rapid Oral Abstract Session: Genitourinary Cancer - Prostate, Testicular, and Penile. Dr. Mark Linch presented results from the NEPTUNES (NCT03061539), a multi-centre two-cohort, biomarker-selected phase 2 trial evaluating Nivolumab (anti-PD1) and ipilimumab (anti-CTLA4) for metastatic prostate cancer with an immunogenic signature.

Dr. Linch initiated his presentation by addressing the limited responses observed with immune checkpoint inhibitor monotherapy in patients with metastatic castration-resistant prostate cancer (mCRPC) (1). This phenomenon is largely attributed to the prevalence of a "cold" tumor immune microenvironment. Anti-CTLA4 therapy has been found to induce T-cell infiltration in prostate cancer, but most importantly, the combination of anti-CTLA4 and anti-PD1 has demonstrated a signal of activity in unselected patients with mCRPC in the preliminary analysis of the CheckMate 650 Trial combining Nivolumab+ipilimumab (2). Moreover, up to 20% of patients with high-risk PCa have high tumor infiltrating lymphocytes (TILs), which have been shown, albeit inconsistently, to be prognostic in PCa. (3)

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