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In patients with relapsed or refractory Hodgkin’s lymphoma, nivolumab, a programmed death-1 (PD-1)-blocking antibody, has substantial therapeutic activity and a satisfactory safety profile, new research suggests. The PD-1 pathway is used by malignant Reed–Sternberg cells in Hodgkin’s lymphoma to evade an immune response, suggest previous studies. According to Stephen Ansell (Mayo Clinic, Rochester, MN, USA) and colleagues, PD-1 ligands are overexpressed on Reed-Sternberg cells, which suggests a genetically determined vulnerability of Hodgkin’s lymphoma to PD-1 blockade. The researchers postulated that in patients with relapsed or refractory Hodgkin’s lymphoma, the PD-1-blocking antibody nivolumab could inhibit immune evasion by the tumour. In a phase 1 trial, Ansell and colleagues assessed the activity and
safety of nivolumab in 23 patients with relapsed or refractory Hodgkin’s lymphoma, who had been pretreated with at least one chemotherapy regimen. Patients were given 3 mg/kg nivolumab every 2 weeks. Drug-related adverse events of any grade were reported in 18 (78%) of 23 patients, and grade 3 drug-related adverse events were reported in five (22%). Of 23 patients, four (17%) had a complete response, 16 (70%) had a partial response, and three (13%) had stable disease. At 24 weeks, the rate of progression-free survival was 86% (95% CI 62–95). 12 patients discontinued treatment; four because of disease progression, two because of toxic effects, and six chose to undergo stem-cell transplantation. The median duration of follow-up was 40 weeks (range 0–75); however, median overall survival had not been reached at the time of writing.
Ansell commented, “PD-1 blockade in heavily-pretreated patients with Hodgkin’s lymphoma resulted in a very high proportion of patients achieving an overall response and clinical benefit in almost all patients.” He added, “Additional studies are in progress to confirm the findings of this phase 1 trial. Future trials, however, are likely to incorporate PD-1 blockade into earlier lines of treatment and even into the initial therapy of patients with newly diagnosed Hodgkin’s lymphoma.” Swapan Jana (Midnapore Medical College, West Bengal, India) commented, “The study yielded promising results; however, larger trials and comprehensive validation of the findings are needed, before introducing nivolumab in Hodgkin’s lymphoma’s treatment.”
Alfred Pasieka/Science Photo Library
Nivolumab shows clinical activity in Hodgkin’s lymphoma
Published Online January 30, 2015 http://dx.doi.org/10.1016/ S1470-2045(15)70024-0 For the study by Ansell and colleagues see N Engl J Med 2015; 372: 311–19
Sanjeet Bagcchi
On Jan 29, 2015, the UK Government announced a £13·7 million investment in stratified medicine. S-CORT, a consortium on colorectal cancer, will receive roughly £2·5 million, half its total funding (Cancer Research UK will provide the remainder). Tim Maughan (Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, UK) is principle investigator of S-CORT. He has suggested that “the future of cancer treatment is personalised or precision therapy,” and points out that 40% of patients with locally advanced rectal cancer do not respond to radiotherapy. “If we could identify who these patients are, we can decide who to treat and eventually tailor the radiotherapy appropriately”, he told The Lancet Oncology. S-CORT also aims to identify patients with more aggressive early-stage disease, and those likely to respond to www.thelancet.com/oncology Vol 16 March 2015
oxaliplatin. Its long-term goal is to develop clinical tests that can predict the success of new therapies. On Jan 30, the US Government provided details of the $215 million Precision Medicine Initiative launched by President Obama earlier this year. The National Institutes of Health will receive $130 million to help establish a nationwide cohort study of at least 1 million volunteers who will provide genomic information and biological specimens. A further $70 million is earmarked for the National Cancer Institute (NCI), to “scale up efforts to identify genomic drivers in cancer and apply that knowledge in the development of more effective approaches to cancer treatment”, according to a White House press release. Harold Varmus (National Cancer Institute, Bethesda, MD, USA) noted that “oncology is the clear choice for enhancing the near-term impact of
precision medicine”. He added that the US initiative will address issues such as drug resistance and the difficulties in monitoring tumour response. Barbara Prainsack (King’s College, London, UK) welcomed the transatlantic announcements, but added words of caution. “Lots of things make one person’s cancer different from another person’s cancer; genetics is a very important player, but it is important not to narrow the focus of personalised medicine to genetic differences alone”, she said. “Otherwise we will miss out on a lot of low-tech solutions that can help us make medicine more targeted and efficient and perhaps also cheaper”. She stressed the importance of linking genetic data with other health information that could help explain why cancer does not materialise in all patients with the same mutations.
Pasieka/Science Photo Library
UK and US governments to fund personalised medicine
Published Online February 6, 2015 http://dx.doi.org/10.1016/ S1470-2045(14)71204-5
Talha Burki e108
In patients with relapsed or refractory Hodgkin’s lymphoma, nivolumab, a programmed death-1 (PD-1)-blocking antibody, has substantial therapeutic activity and a satisfactory safety profile, new research suggests. The PD-1 pathway is used by malignant Reed–Sternberg cells in Hodgkin’s lymphoma to evade an immune response, suggest previous studies. According to Stephen Ansell (Mayo Clinic, Rochester, MN, USA) and colleagues, PD-1 ligands are overexpressed on Reed-Sternberg cells, which suggests a genetically determined vulnerability of Hodgkin’s lymphoma to PD-1 blockade. The researchers postulated that in patients with relapsed or refractory Hodgkin’s lymphoma, the PD-1-blocking antibody nivolumab could inhibit immune evasion by the tumour. In a phase 1 trial, Ansell and colleagues assessed the activity and
safety of nivolumab in 23 patients with relapsed or refractory Hodgkin’s lymphoma, who had been pretreated with at least one chemotherapy regimen. Patients were given 3 mg/kg nivolumab every 2 weeks. Drug-related adverse events of any grade were reported in 18 (78%) of 23 patients, and grade 3 drug-related adverse events were reported in five (22%). Of 23 patients, four (17%) had a complete response, 16 (70%) had a partial response, and three (13%) had stable disease. At 24 weeks, the rate of progression-free survival was 86% (95% CI 62–95). 12 patients discontinued treatment; four because of disease progression, two because of toxic effects, and six chose to undergo stem-cell transplantation. The median duration of follow-up was 40 weeks (range 0–75); however, median overall survival had not been reached at the time of writing.
Ansell commented, “PD-1 blockade in heavily-pretreated patients with Hodgkin’s lymphoma resulted in a very high proportion of patients achieving an overall response and clinical benefit in almost all patients.” He added, “Additional studies are in progress to confirm the findings of this phase 1 trial. Future trials, however, are likely to incorporate PD-1 blockade into earlier lines of treatment and even into the initial therapy of patients with newly diagnosed Hodgkin’s lymphoma.” Swapan Jana (Midnapore Medical College, West Bengal, India) commented, “The study yielded promising results; however, larger trials and comprehensive validation of the findings are needed, before introducing nivolumab in Hodgkin’s lymphoma’s treatment.”
Alfred Pasieka/Science Photo Library
Nivolumab shows clinical activity in Hodgkin’s lymphoma
Published Online January 30, 2015 http://dx.doi.org/10.1016/ S1470-2045(15)70024-0 For the study by Ansell and colleagues see N Engl J Med 2015; 372: 311–19
Sanjeet Bagcchi
On Jan 29, 2015, the UK Government announced a £13·7 million investment in stratified medicine. S-CORT, a consortium on colorectal cancer, will receive roughly £2·5 million, half its total funding (Cancer Research UK will provide the remainder). Tim Maughan (Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, UK) is principle investigator of S-CORT. He has suggested that “the future of cancer treatment is personalised or precision therapy,” and points out that 40% of patients with locally advanced rectal cancer do not respond to radiotherapy. “If we could identify who these patients are, we can decide who to treat and eventually tailor the radiotherapy appropriately”, he told The Lancet Oncology. S-CORT also aims to identify patients with more aggressive early-stage disease, and those likely to respond to www.thelancet.com/oncology Vol 16 March 2015
oxaliplatin. Its long-term goal is to develop clinical tests that can predict the success of new therapies. On Jan 30, the US Government provided details of the $215 million Precision Medicine Initiative launched by President Obama earlier this year. The National Institutes of Health will receive $130 million to help establish a nationwide cohort study of at least 1 million volunteers who will provide genomic information and biological specimens. A further $70 million is earmarked for the National Cancer Institute (NCI), to “scale up efforts to identify genomic drivers in cancer and apply that knowledge in the development of more effective approaches to cancer treatment”, according to a White House press release. Harold Varmus (National Cancer Institute, Bethesda, MD, USA) noted that “oncology is the clear choice for enhancing the near-term impact of
precision medicine”. He added that the US initiative will address issues such as drug resistance and the difficulties in monitoring tumour response. Barbara Prainsack (King’s College, London, UK) welcomed the transatlantic announcements, but added words of caution. “Lots of things make one person’s cancer different from another person’s cancer; genetics is a very important player, but it is important not to narrow the focus of personalised medicine to genetic differences alone”, she said. “Otherwise we will miss out on a lot of low-tech solutions that can help us make medicine more targeted and efficient and perhaps also cheaper”. She stressed the importance of linking genetic data with other health information that could help explain why cancer does not materialise in all patients with the same mutations.
Pasieka/Science Photo Library
UK and US governments to fund personalised medicine
Published Online February 6, 2015 http://dx.doi.org/10.1016/ S1470-2045(14)71204-5
Talha Burki e108
![[Personalised medicine].](/assets/img/hold.png)
