When will immunotherapy benefit more? 2022 ESMO Reveals the Answer!

*For medical professionals only

Used before surgery, the risk of death is reduced by 37%!

Immunotherapy is good for early use, how early should this "early" be? Is it enough to apply it early in the disease, or should immunotherapy be used as early as possible even for early disease?
Recently, at the European Society for Internal Oncology (ESMO) conference, a study by S.
Patel and others at MD Anderson Cancer Center gave the answer: the sooner the better
.
Moving 3 doses of a total of 18 doses of pabolizumab (K drug) in melanoma patients to surgery alone can reduce the risk of adverse events and the risk of death by 37% [1].


Marching and fighting wars must be based on the advantages of heaven and place, and the same is true for the treatment of
diseases.

For example, immunotherapy, it needs to mobilize the patient's own immunity, if it is used too late, the patient's physical condition has been greatly reduced under the torment of the disease, the immunity is not strong, even if the use of immunotherapy may not be able to mobilize the patient's immune function
.

Because of this, the timing of the application of immunotherapy has been moving forward
since its inception.
From the initial use of advanced patients without treatment, to the first-line treatment of advanced patients, to the adjuvant treatment after surgery and even the neoadjuvant treatment
before surgery.

The S1801 study, announced at the ESMO Annual Meeting, adds evidence
to the timely use of re-immunotherapy.

A total of 313 patients with stage IIB to IV melanoma who were preparing for surgery were enrolled in this study and were divided into two groups:

• Adjuvant treatment group of 159 people, direct surgery, postoperative use of 18 doses of K drugs;
  
• In the neoadjuvant treatment group, 154 people were first treated with 3 doses of K drugs before surgery, and 15 doses of K drugs
  were used after surgery.
  

Both groups of patients in the study received a total of 18 doses of drug K, but the efficacy was completely different
.

After a median follow-up of 14.
7 months, adverse events such as relapse, death, or inability to receive treatment as planned occurred within 2 years in 51% of patients in the adjuvant therapy group, compared with only 28% of patients in the neoadjuvant treatment group who had these events
within 2 years.
Neoadjuvant therapy reduced the risk of adverse events and the risk of death by 37% compared with adjuvant therapy
.


Specifically, by the time the surgery was completed, 14 and 20 adverse events had occurred in the neoadjuvant treatment group and 20 in the adjuvant treatment group, respectively, and the gap was not large
.
In the postoperative adjuvant treatment stage, 24 cases and 47 adverse events occurred in the two groups, respectively, with obvious
differences.
Neoadjuvant therapy before surgery not only does not increase the risk of adverse events before surgery, but also significantly reduces postoperative adverse events
.

Dr Patel said: "According to the findings of S1801, high-risk melanoma patients should start immunotherapy before surgery to generate an immune response
with the majority of melanoma and anti-tumor T cells intact.
Future research could explore downgrade strategies for surgery and adjuvant therapy, as well as treatment approaches for patients who do not respond to neoadjuvant therapy
.
”

References:

[1].
https://oncologypro.
esmo.
org/meeting-resources/esmo-congress/neoadjvuant-versus-adjuvant-pembrolizumab-for-resected-stage-iii-iv-melanoma-swog-s1801

Source of this article: Dong Dong Cancer Circle This
article Author: Dong Dong Medical Department Responsible Editor: Sweet copyright
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