Final Thoughts on Immunotherapy

Transcript:Mark A. Socinski, MD: Gentlemen, this has been an extremely informative panel discussion. What I want to do in the few minutes we have remaining is just get some final thoughts. I’ll start with Jared. What’s the message you want to go out about immunotherapy across solid tumors?

Jared M. Weiss, MD: I think there are a lot of possible messages. I’ll leave you with one. I think we’ve had a very T cell-centric conversation today. We’ve spoken a little bit about antigen presentation, we’ve spoken some about other factors in the immune system. But, over the past 3 years, I felt like a medical student again, as I go back and re-study my immunology. And the more I study, the less I think that I know. And I think as we develop more therapeutics, we’re going to talk about more complex components of immune suppression beyond just T-cell anergy. We’re going to be talking about suppressive B cells, suppressive monocytes, all kinds of other suppressive components. I think antigen presentation is going to become relevant again, once we can make it relevant with some of these agents. And I think we’re starting to finally see some preclinical data on potential therapeutic approaches to the innate immune system. So, we can look forward to this becoming a whole lot more complex, if it’s not complex enough already. And we can look forward to seeing real clinical victories as a consequence of that.

Mark A. Socinski, MD: Dean.

Dean F. Bajorin, MD: So, when I think of cancer, I think it’s a disease whose sole purpose is to consume the host. And, now, we have something that can help the host. Everything we’ve done up until a few years ago has really been to fight the cancer, usually chemotherapy. But, now we have tools that really help an individual fight his or her own tumor. That’s really, for me, paradigm shifting, and for our patients as well. One of my patients who is in CR is a sailor. He bought a new boat, and he named it Miracle. I think that’s where I stand, it sums it up. A little while, at Christmas time, I was asked what I want for Christmas and I said to our research team, “I want biopsies, biopsies, and more biopsies.” And the reason I see this is that we’re looking at biomarkers to try to correlate with response. We really don’t have a marker that says yes or no like targeted therapy. But, as we treat, we’re going to have more patients developing resistance to therapy, just like we have with regard to targeted therapy. And we really need to dissect out not just the response. It’s highly complex, but we actually need to dissect out resistance as well. Because, that’s where we need to funnel some of our research resources.

Mark A. Socinski, MD: Howard.

Howard L. Kaufman, MD: My final thought is that the real power of immunotherapy is in the durability of the response. And I think when we see this tail on the curve going out and out and out, it’s really just amazing. So, it’s important to remember that we’re talking about potentially giving patients not days or weeks, but months or years. We have good reason to be optimistic. I think the real advantage here is that when a response does occur—and I agree we need to understand why, we need to measure it, and we need the biomarkers—but we’re talking about potentially long-term responses when this happens.

Mark A. Socinski, MD: And John.

John V. Heymach, MD, PhD: From my perspective, immunotherapy isn’t a promising treatment approach. It’s actually a standard now, and the work is to figure out how to maximize the benefit that patients get from it. Like other new treatments, we’ve started in the most advanced patients in lung cancer. For example, those that already were refractory to standard chemotherapy, we see the benefit they get. But, I’m very excited about the possibility now of moving into earlier stage patients that have less disease where we can increase the cures, even to patients who are getting their tumors cut out. Because, even if you get your lung cancer resected, you’ve got a 50% chance or so of it coming back. Can we use the immune system to prevent that from happening? And then, use the combinations with other types of treatments that are successful, like targeted agents and tyrosine kinase inhibitors. So, more combinations and earlier stage diseases are the two big trends I’m excited about for immunotherapy.

Mark A. Socinski, MD: Well, gentlemen, thanks to all of you for your contributions to this discussion. On behalf of our panel, we thank you for joining us, and we hope you found this peer-exchange discussion to be useful and informative.

Transcript Edited for Clarity