Immunotherapy combination shows promise in advanced melanoma

CANCER DIGEST – April 15, 2017 – A new treatment  regimen using an immunotherapy drug combined with an engineered virus injected directly into a melanoma tumor have shown promising results in an early safety trial of the combination.

The preliminary results were presented at the American Association for Cancer Research (AACR) meeting last week in Washington, D.C. by researchers at the Providence Cancer Center in Portland, OR. 

The study combined the immunotherapy drug ipilimumab (Yervoy) with a modified cold virus, called Coxsackievirus (CAVATAK)  engineered to infect tumor cells.  CAVATAK seeks out and attaches to a protein that is highly expressed on the surface of many cancer cells (ICAM-1). Once attached, the virus is then inserts itself into the cancer cell, replicates, and bursts the cancer cell apart, a process known as lysis. 

The combination treatment was given to 25 patients who had advanced melanoma that progressed following other treatments. Of 22 patients who could be evaluated before the presentation at the conference, four patients had a complete response, meaning tumors were eradicated, and seven patients had a partial response, meaning the tumors shrank following the treatment. 

This 50 percent overall response rate was significantly higher than the overall response rate of 11 percent for ipilimumab alone and the 28 percent overall response rate for the CVA21 alone. Only two patients experienced severe side-effects (grade three or higher.)

“While still a small data set, we are encouraged by the low frequency of severe adverse events,” said said Brendan D. Curti, MD, co-director of the Melanoma Program at Providence. “Historically, about 25 percent of patients treated with ipilimumab have treatment-related grade three or higher adverse events. We have seen this in just 8 percent of patients treated with the combination, but we will need larger numbers of patients to confirm this finding.”

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