Long-term Survival Data With Immunotherapy in Gynecologic Cancers

In this fourth episode of OncChats: Immunotherapy and You, John Nakayama, MD, and Ali Amjad, MD, highlight long-term survival data reported with immunotherapy approaches in patients with gynecologic cancers.

In this fourth episode of OncChats: Immunotherapy and You, John Nakayama, MD, of the Division of Gynecologic Oncology, Allegheny Health Network, and assistant professor of OBGYN at Drexel University, and Ali Amjad, MD, medical hematologic oncologist, Allegheny Health Network, highlight long-term survival data reported with immunotherapy approaches in patients with gynecologic cancers.

Nakayama: Dr Amjad, I know you put together a little slide for us looking at [immunotherapy approaches in] a variety of cancers that have had more long-term data, as opposed to some of the [data] that I might be more familiar with. Could you take us through what was first? Why it was so important? What do you see [in terms of] survival with immunotherapy?

Amjad: Yeah. As you can see in the slide, this is a recent update from the 2022 ASCO Annual Meeting, which describes the longest follow-up for these patients with combination immunotherapy of ipilimumab [Yervoy] and nivolumab [Opdivo]. Here are just 3 examples. 

As we know, melanoma was the first cancer where immunotherapy was implemented and discovered, and we now have 7-year and beyond survival [information]. As you can see, approximately 1 in 2 patients who would otherwise have survived only a few months, when they went on these clinical trials with combination immunotherapy, are now doing well. Many of these treatments were stopped at 2 years after they started, based on protocol requirements. These patients are off therapy, and they're doing well many, many years after they were diagnosed with a stage IV, life-limiting illness. Similarly, in lung cancer, we have a good outcome. We had a recent update at 5 years [which showed that] 1 in 4 patients are alive. Also, in kidney cancer, again, we see tremendous improvement in survival. In the pre-immunotherapy era, you can see survival [outcomes in these populations] were poor.

Nakayama: That's wild to me. I remember the days of vulvar melanoma, where people were getting interleukin-2 [IL-2], and were just really, really sick and just did not have very good outcomes. Is that what you have seen, as well? [Immunotherapy] is probably less toxic and works better.

Amjad: Yeah, IL-2 was, again, a unspecific way to stimulate the immune system, and that had been used for a long time in melanoma in general. In that crossfight between the inflammation that is induced by IL-2, and the cancer and the host, we used to have some success with a small number of people—[only] single digits. However, with these more refined immunotherapies, we now see a lot more patients responding and staying in response for a long time.

Nakayama: That's wonderful. 

Check back next Wednesday to view the next segment in this series.

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