Immunotherapy, which works by helping the immune system identify and eliminate cancer cells, has been shown to improve long-term overall survival in patients with advanced melanoma, according to the results of major international studies presented at the European Society for Medical Oncology (ESMO 2024) congress. which is celebrated these days in Barcelona.
The researchers responsible for the The largest follow-up study to date suggests it may offer a chance for a cure in patients who respond favorably to treatment. In addition, other clinical trials also presented at the congress demonstrate an increase in long-term survival when immunotherapy is administered before and after surgery in early-stage, difficult-to-treat breast cancer (triple negative), as well as in muscle-invasive bladder cancer.
We are seeing numerous studies in various types of tumors showing that immunotherapy can have long-lasting effects, says Alessandra Curioni-Fontecedro, professor of oncology at the Fribourg Hospital in Switzerland.
Results from a phase 3 trial of PD-1 inhibitor-based immunotherapy showed a sustained benefit in long-term survival in patients with advanced melanoma. After a Follow-up of at least 10 years, the median overall survival reached 71.9 months (about six years) in patients who received the immunotherapy combination of nivolumab and ipilimumab in the CheckMate 067 study. Most of those who initially responded well and did not experience disease progression for at least three years were still alive a decade later without dying from melanoma (with a 96% survival rate at 10 years).
The researchers said these treatments now offer curative potential for patients who respond well. The results of this trial confirm the curative potential of immunotherapy in patients with advanced melanoma, said Marco Donia, associate professor of clinical oncology at the Danish National Centre for Cancer Immunotherapy at Copenhagen Herlev Hospital, Denmark, who was not involved in the study.
He further comments: For patients who do not show disease progression after three years, these long-term results show that Most of them do not experience further progression. Melanoma-specific survival is extremely high in that group.
Importantly, the long-term survival benefit with immunotherapy is also seen in routine clinical practice, outside of clinical trials, Donia continues. Immunotherapy has transformed advanced melanoma from what was once a fatal disease with a median survival of less than a year to what we see today, with half of patients surviving many years. In her opinion, This raises practical questions about how best to follow up these patients.such as whether they require long-term reviews.
An improvement in overall survival has also been seen with immunotherapy in early-stage triple-negative breast cancer (TNBC) and muscle-invasive bladder cancer. Triple-negative breast cancers are particularly difficult to treat because they do not have estrogen or progesterone receptors or high levels of HER2, so they do not respond to standard treatments. The results showed a statistically significant and clinically meaningful improvement in overall survival with immunotherapy plus chemotherapy before surgery and continued immunotherapy after surgery; The overall five-year survival rate was 86.6% in patients who received immunotherapy and 81.2% in the placebo group.
The Niagara Study
On the other hand, a study of patients with muscle-invasive bladder cancer showed a similar improvement in overall survival with the administration of immunotherapy before surgery. The phase 3 Niagara trial randomly assigned patients to immunotherapy with durvalumab plus chemotherapy before radical cystectomy, followed by continued immunotherapy, or to chemotherapy alone before surgery. Patients treated with immunotherapy showed significantly longer event-free survival and overall survival compared with those who received chemotherapy alone.
The researchers found that administration of immunotherapy before surgery did not compromise the ability to perform radical cystectomy, which was completed in 88% of the immunotherapy group and 83% of the control group. This is the first immunotherapy before and after surgery that has results on the survival curve.