Immunotherapy trials in sarcomas review

[Olga]

There is a new review article written by a collaborative group of the few US sarcoma expects posted in ESUN ImmunoSarc:
Understanding the Immune Response in Sarcomas
http://sarcomahelp.org/immunosarc.html#tpm2_2
they systematize what is known at this point about immune response in sarcomas and the Immune signalling molecules that act to shut down or dampen the immune response, so they are the targets of the immunotherapy trials, between them we can see the PDL group (we already have our patients in a corresponding trials).
There is one important detail that was discussed on a sarcoma mailing list - that it is noted that sarcomas often increase in size at the initial part of the trial with the delayed shrinkage. It was said that the immune response causes the tumor initially swell and it is often mistakenly viewed as a growth on a trial and the patient is taken off the trial. There are cases when even though the drug was stopped after the patient was taken off the trial, there was a shrinkage a week or two later but the patient was no allowed back on a trial as per current trials regulations. This specific situation will not be of concern on a trial of Phase 1 when they only study tolerability, toxicity and max tolerable dose finding - the response is a secondary target there, but this situation will be of a big concern on a trial of Phase 2 when they study a response and the patients with more than 25% of progression are taken off the trial.

[D.ap]

Olga
The above link is very interesting indeed.

I found another article along the same lines that I will be looking at and seeing what more can be drawn upon specific to sarcomas.


Sarcoma Immunotherapy: Past Approaches and Future Directions

Abstract

Sarcomas are heterogeneous malignant tumors of mesenchymal origin characterized by more than 100 distinct subtypes. Unfortunately, 25–50% of patients treated with initial curative intent will develop metastatic disease. In the metastatic setting, chemotherapy rarely leads to complete and durable responses; therefore, there is a dire need for more effective therapies. Exploring immunotherapeutic strategies may be warranted. In the past, agents that stimulate the immune system such as interferon and interleukin-2 have been explored and there has been evidence of some clinical activity in selected patients. In addition, many cancer vaccines have been explored with suggestion of benefit in some patients. Building on the advancements made in other solid tumors as well as a better understanding of cancer immunology provides hope for the development of new and exciting therapies in the treatment of sarcoma. There remains promise with immunologic checkpoint blockade antibodies. Further, building on the success of autologous cell transfer in hematologic malignancies, designing chimeric antigen receptors that target antigens that are over-expressed in sarcoma provides a great deal of optimism. Exploring these avenues has the potential to make immunotherapy a real therapeutic option in this orphan disease.

Ie rare low percentage of cancers, disease

http://www.hindawi.com/journals/sarcoma/2014/391967/

Thanks for sharing
Love
Debbie

Ps if need be I sure can move this to medical sub forum