Dr Bryant on Utilizing Nivolumab With SOC in Grade Group 5 Prostate Cancer

John Michael "JM" Bryant, MD, radiation oncology resident, Moffitt Cancer Center, discusses the combination of nivolumab (Opdivo) with standard of care (SOC) in the management of patients with prostate cancer, detailing the results of the interim analysis of the phase 2 trial (NCT03543189).

The single-center, single-arm study investigated the safety and tolerability of nivolumab when given in combination with high-dose radiation and androgen deprivation therapy (ADT), and to evaluate the combination’s effectiveness in delaying disease progression. Findings presented at the 2023 AACR Annual Meeting showed that the addition of nivolumab to radiation and ADT led to an 88% reduction in the 2-year risk of metastasis vs a historical control arm that consisted of patients with grade group 5 prostate cancer treated with SOC alone at Moffitt Cancer Center from January 2013 to November 2021 who met the study’s inclusion criteria.

Moreover, biopsies taken at the time of diagnosis, prior to both factions of brachytherapy, and one month following radiation, Bryant explains. With this approach, investigators gathered genomic data and found that CD8A, STING, ANPEP, and multiple immune signatures were associated with an early major pathologic response (MPR). Additionally, the Ricketts Immunosuppression genomic signature was strongly associated with MPR, Bryant continues.

Given the clinically significant reduction in 2-year risk of metastasis observed in this interim analysis, more investigations into genomic signatures associated with MPR could help better identify which patients would most benefit from the addition of nivolumab to SOC, Bryant concludes.