Saturday, 20 October 2018

Neoadjuvant treatments by Christian Blank

Why treating early stage patients?

Early stage patients have all the favourable disease outcomes that we know from Stage 4

cancer immunogram

Why treating neoadjuvant

1. we know whether therapy was effective
2. we can reduce tumour burden very fast- easier surgery
3. we can use pathological response as an outcome parameter
4. in case of checkpoint- inhibitors induces a broader and deeper expansion of T-cell clones
5. easier baseline biomarker identification 

pure neo-adjuvant with 12 weeks: still relapses, so not the way to go
(Georgina Long's work)

Opacin trial

neo-adjuvant seems better than adjuvant- and patients do not relapse

get slides

Problem: very high toxicity

and PD1 monotherapy neo-adjuvant considerably lower response rate when compared to Ipi plus Nivo

also longer treatment with PD1 not successful

so which way to go?

OPACIN- neo trial- late breaker on Monday

lower ipi dose in combination
altered admin scheme

Personalised immunotherapy

'test your favourite combinations in neo-adjuvant' NAHHHH
and you will chose the *most promising* option, so time for research!

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