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Maximizing the value of phase III trials in immuno-oncology: A checklist from the Society for Immunotherapy of Cancer (SITC)

Authors :
James L Gulley
James Larkin
Leisha A Emens
Mario Sznol
Madhav Dhodapkar
Daniel S Chen
Roy S Herbst
Tim F Greten
Robert L Ferris
Luca Mazzarella
Paolo A Ascierto
Marc S Ernstoff
Michael B Atkins
Kim A Margolin
Brian I Rini
Michael R Bishop
Suresh S Ramalingam
Meredith M Regan
Rachel W Humphrey
Source :
Journal for ImmunoTherapy of Cancer, Vol 10, Iss 9 (2022)
Publication Year :
2022
Publisher :
BMJ Publishing Group, 2022.

Abstract

The broad activity of agents blocking the programmed cell death protein 1 and its ligand (the PD-(L)1 axis) revolutionized oncology, offering long-term benefit to patients and even curative responses for tumors that were once associated with dismal prognosis. However, only a minority of patients experience durable clinical benefit with immune checkpoint inhibitor monotherapy in most disease settings. Spurred by preclinical and correlative studies to understand mechanisms of non-response to the PD-(L)1 antagonists and by combination studies in animal tumor models, many drug development programs were designed to combine anti-PD-(L)1 with a variety of approved and investigational chemotherapies, tumor-targeted therapies, antiangiogenic therapies, and other immunotherapies. Several immunotherapy combinations improved survival outcomes in a variety of indications including melanoma, lung, kidney, and liver cancer, among others. This immunotherapy renaissance, however, has led to many combinations being advanced to late-stage development without definitive predictive biomarkers, limited phase I and phase II data, or clinical trial designs that are not optimized for demonstrating the unique attributes of immune-related antitumor activity—for example, landmark progression-free survival and overall survival. The decision to activate a study at an individual site is investigator-driven, and generalized frameworks to evaluate the potential for phase III trials in immuno-oncology to yield positive data, particularly to increase the number of curative responses or otherwise advance the field have thus far been lacking. To assist in evaluating the potential value to patients and the immunotherapy field of phase III trials, the Society for Immunotherapy of Cancer (SITC) has developed a checklist for investigators, described in this manuscript. Although the checklist focuses on anti-PD-(L)1-based combinations, it may be applied to any regimen in which immune modulation is an important component of the antitumor effect.

Details

Language :
English
ISSN :
20511426
Volume :
10
Issue :
9
Database :
Directory of Open Access Journals
Journal :
Journal for ImmunoTherapy of Cancer
Publication Type :
Academic Journal
Accession number :
edsdoj.924c88f5ec8f4838a91c8255c8c43862
Document Type :
article
Full Text :
https://doi.org/10.1136/jitc-2022-005413