anti-PDL 1, anti-PD 1 - 1259996

I haven't heard that -- haven't heard anything either way about response rates in patients with EGFR mutations and imagine we're probably talking about quite small numbers, likely anecdotal experience. Considering that we're talking about an agent/class of agents with a response rate of 20-25%, potentially having a collective experience of very few responders among perhaps one or at most a couple of dozen patients with an EGFR mutation seems like a very small sample from which to draw broad conclusions.

It may well be true, as further evaluation may tell, but I think most lung cancer specialists are wary about interpreting too much too early.

-Dr. West

There is a hint of data emerging that smoking history seems to correlate with higher response rate to this class of anti-PD-L1/PD1 drug. Nothing firm has been reported on this yet though, except for the upcoming World Lung Conference this month. There is currently an effort by researchers to look back to correlate response with factors like mutation status in available patients, although this is really just idea-forming research. The bottom line, as Dr West says, is that there isn't enough information yet to draw conclusions.

I should say that, as Dr. Creelan noted, I have also heard that we're going to be seeing data that people with a history of smoking have a greater probability of benefit with the immune checkpoint inhibitors. That should be an interesting angle for future development of these agents.

-Dr. West

abstracts for the conference are here, http://abstracts.webges.com/wclc2013/myitinerary

How right you are, SSFLXL. Darn it. I even had a referral to that trial but I waited too long...Cohort 2 (previous treatment exposure) is closed. Oh well. On to MK-3475 I suppose. I've just been told late November - early December for Clovis trial. So in the meantime I guess I'll just let Merck/UCLA do the biopsy...

It works well if it works, but if you've got nothing else to try, it's probably as good a bet as Navelbine (in my case). How are you, SSFLXL?

Jazz

ssflxl,

Looking at the Stanford website, I'm surprised to hear the Phase 2 MPDL3280A trial is closed, as they just opened it and on clinicaltrials.gov it actually says "Not Yet Recruiting". The Phase 1 for solid tumors remains open EXCEPT to Lung, as that's what the Phase 2 trial is for (Lung only). However, at Angeles Clinic and others around the country that have had the trial open for awhile, Cohort 2 (previously treated) of the Phase 2 trial is closed.

I believe UCLA is opening the trial but I don't see it on their website. I was told in August it would open in "about 3 months". Meanwhile the plan is to enroll on Monday (4th) in the MK-3475 trial, get biopsy done there, if positive will go forward, if negative hopefully a CO-1686 slot will be available... At this point, I'd just like to avoid Cisplatin-Navelbine - didn't realize I'd need a port/central line and it's a 7-hour infusion (which really means 9 hours, from my experience)

Dr. Garon of UCLA presented the prelim data on MK3475 in lung cancer at the IASLC conference in Australia, so they're hot to enroll people. They think the data is solid - 25% RR in PDL-1 positive and some response in the negative patients. I don't favor the agent due to the pneumonitis side effect (not good for one-lungers like me), but I'm assured it's "only 4%". To me that's high but I'm told Merck pays for everything and I wouldn't even have to bother with a Kaiser referral. We'll see about that! I'll keep you posted.

You're lucky to have an almost full "arsenal" of options still available. I hope you can ride out the holidays as well. You're a trooper :) Don't wait too long though - stay healthy. Do you attend the Bonnie Addario Lung Cancer Living Room meetings?

Cheers,
Jazz