ESMO Reaction
September 15, 2022

ESMO Reactions: S1801

ESMO Reaction
September 15, 2022

ESMO Reactions: S1801

Author

Neoadjvuant versus adjuvant pembrolizumab for resected stage III-IV melanoma (SWOG S1801)

Abstract #LBA6: Sapna Patel presented results of the P2 SWOGS1801 trial comparing adjuvant therapy (AT) (n=154) vs neoadjuvant therapy (NAT) (n=159) with pembrolizumab in patients with histologically confirmed, measurable, clinically detectable and resectable Stage IIIB-IV cutaneous,acral and mucosal melanomas without brain metastasis.

Results: After a median follow-up of 14.7 months, event free survival (EFS) was significantly higher on NAT compared to AT. 2-year EFS was 72% in the NAT arm vs49% in the AT arm. Benefit consistent across age, sex, performance status, stage, LDH, ulceration and BRAF status. Rates of adverse events were similar in both arms. In the NAT arm, available pathology reports (21%of patients) all showed complete pathologic response (0% viable tumor)on local review.

Thought leader reactions: Decidedly positive and “practice changing”for resectable stage 3-4 melanoma; neoadjuvant pembrolizumab led to significantly improved EFS vs. adjuvant with few AEs

Thought leaders also saw the data as demonstrating the broader value of neoadjuvant immunotherapy in melanoma

Encouraged by the results, some thought leaders suggested that similar comparisons should be made in other carcinomas (thoracic, uterine, bladder)

Summary:

The P2 S1801 data demonstrates that neoadjuvantpembrolizumab followed by adjuvant pembrolizumab significantly improvesEFS in resectable stage 3-4 melanoma.Thought leaders in the space are very excited about the possibilities of neoadjuvant pembro (and other neoadjuvant immunotherapies) and keen to see similar trials in other cancers.

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Not rated
Allison Betof Warner, MD, PhD (she/her) 4
3743
Manhattan, NY
November 10, 2022

79% had reduction in disease. ORR 31%. Many responses deepen over time.

Not rated
Allison Betof Warner, MD, PhD (she/her) 3
3743
Manhattan, NY
November 10, 2022

Median DOR not yet reached. Median OS 13.9 mo. 12 mo OS was 54%. As typical with immunotherapy, we see a nice tail on the curve. #TIL#SITC22

Positive
Alex Shoushtari, MD
2253
New York, USA
November 10, 2022

Important work on efficacy of TIL therapy lifileucel in PD-1 resistant #melanoma being presented at #SITC22. Pretty good durability for this heavy lift of a treatment.

Not rated
Allison Betof Warner, MD, PhD (she/her) 2
3743
Manhattan, NY
November 10, 2022

Toxicity profile was in line with prior TIL/Lifileucel data. No surprises here. Median # doses of IL-2 was 6.

Positive
Hussein Tawbi, MD, PhD
1685
Houston, TX
November 10, 2022

Absolutely agree!… this should be available to our melanoma patients ASAP!… and paves the way for smarter cellular therapies to be designed, studied, and eventually widely disseminated

Positive
Allison Betof Warner, MD, PhD (she/her) 1
3744
Manhattan, NY
November 10, 2022

Where does this leave us with #TIL therapy for #melanoma? IMO, this response rate/durability justifies accelerated approval. Pts with PD-1 refractory melanoma need options. It’s FAR from a perfect tx but provides meaningful clinical benefit. What say you melanoma Twitterverse?

Not Rated
Sumanta K. Pal, MD, FASCO
15083 Followers
Los Angeles, CA
November 8, 2022

Just before I start AM clinic at @cityofhopeoc, excited to share results from #COBALT_RCC, a P1 trial of @CRISPRTX#CTX130 in #kidneycancer in the @sitcancer#PressProgram. Will present more on Thurs 5:37p at #SITC22! Thx @neerajaiims@DrBenTran@HaanenJohn#SamerSrour& co-Is! t.co/aDnhG9n92A

not rated
Shilpa Gupta
5095 Followers
Cleveland, OH
November 8, 2022
Not Rated
Tian Zhang, MD, MHS
6463 Followers
Dallas, TX
November 8, 2022

CAR-Ts are coming for #kidneycancer!! Congratulations @montypal and team; can’t wait to see results at #SITC22! t.co/9MrlF2yzBe

Not Rated
Moshe Ornstein MD
1930 Followers
Cleveland, OH
November 8, 2022

Congrats @montypal and team! Great to see CAR T therapy coming to #RCCt.co/ypRHBC89Pt

Not Rated
Shuchi Gulati MD
12476 Followers
Seattle, WA
November 8, 2022

Another huge step from none other than @montypal!! CAR-Ts in #kidneycancer!Congratulations to the entire team!Looking forward to seeing the results at #SITC22! t.co/HvKeVBPyV7

Not Rated
Petros Grivas
12476 Followers
Seattle, WA
November 8, 2022

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