At Yale, we’re one of the first sites to look at ipilimumab (Yervoy) and nivolumab (Opdivo) together, or tremelimumab and durvalumab together. We’ve all learned about the different toxicities and side effects, and we’ve learned how to manage them and be aggressive early on in that management.What are some of the remaining challenges with immunotherapy in the first-line setting, and how can they be addressed?
Immunotherapy clearly is a new paradigm in the first-line setting. Using it for patients who have PD-L1 staining of more than 50%, that’s only about 20% to 25% of patients. The challenge is to figure out, what about the other 75%? Should they get a PD-L1 or PD-1 inhibitor alone? Should they get it in combination with something else? Should they get chemotherapy followed by a PD-1/PD-L1 inhibitor? All of these trials and sequences need to be studied with molecular characteristics identified from the get-go.What would you like the community oncologist to ultimately take away from your presentations here at the meeting?
Immunotherapy is a critical part of the armamentarium, and oncologists are doing the right thing by using it. And they can tell their patients that there are chances for very good outcomes, but there are also limitations; not everyone benefits. We are going to need new trials and to understand biomarkers better, and also learn about how to manage toxicity, as well as how we can educate one another regarding that.