Researchers at Mount Sinai’s Tisch Cancer Institute in New York reported the results of a small phase 2 trial in the January 2022 journal The Lancet Gastroenterology & Hepatology.
The results showed that the immunotherapy killed not only more of the tumor but microscopic cancer cells that likely would have been missed by surgery, and would potentially cause the tumor to regrow and spread.
Dr. Thomas Marron, lead author and director of the Early Phase Trials Unit at the Tisch Cancer Institute said the results hold implications for other types of cancers, not just liver cancer in terms of administering immunotherapy before or after surgery.
“Ultimately, we think it’s better for the patient to receive immunotherapy before surgery because people are healthier before metastases, and their immune systems are in better shape to fight off the cancer,” Marron said in a press release. "This study, together with neoadjuvant immunotherapy trials in many other types of tumors, supports the need for continued evaluation of perioperative immunotherapy to decrease recurrence rates.”
He adds that cancer recurrence is typically incurable, so larger trials using neoadjuvant or immunotherapy prior to other treatments is needed to further define the usefulness and effectiveness of this approach.
In the study 21 patients with early stage liver cancer were given two rounds of the immunotherapy agent cemiplimab (Libtayo®) before undergoing surgery, followed by an additional eight rounds of cemiplimab. The researchers followed the patients measuring tumor death using MRI studies along with blood, stool and tissue sample analysis. They found in 7 of the patients (33%) a substantial portion of the tumor was killed before surgery.
In addition, they noticed that patients whose immune systems were already fighting the cancer had greater tumor death before surgery, suggesting the immunotherapy revved up the immune response to the cancer. To measure that increased immune response, the researchers used new method of profiling the immune response to the immunotherapy, called TARGET, which was developed by a collaboration of researchers and clinicians. It provides a much more detailed view of tumor response using serial biopsies, stool samples and blood analysis.
The research team is continuing to follow the patients in this study to see if greater tumor death ultimately results in better outcomes.
Sources: Mount Sinai press release and The Lancet Gastroenterology & Hepatology.
Dr. Thomas Marron, lead author and director of the Early Phase Trials Unit at the Tisch Cancer Institute said the results hold implications for other types of cancers, not just liver cancer in terms of administering immunotherapy before or after surgery.
“Ultimately, we think it’s better for the patient to receive immunotherapy before surgery because people are healthier before metastases, and their immune systems are in better shape to fight off the cancer,” Marron said in a press release. "This study, together with neoadjuvant immunotherapy trials in many other types of tumors, supports the need for continued evaluation of perioperative immunotherapy to decrease recurrence rates.”
He adds that cancer recurrence is typically incurable, so larger trials using neoadjuvant or immunotherapy prior to other treatments is needed to further define the usefulness and effectiveness of this approach.
In the study 21 patients with early stage liver cancer were given two rounds of the immunotherapy agent cemiplimab (Libtayo®) before undergoing surgery, followed by an additional eight rounds of cemiplimab. The researchers followed the patients measuring tumor death using MRI studies along with blood, stool and tissue sample analysis. They found in 7 of the patients (33%) a substantial portion of the tumor was killed before surgery.
In addition, they noticed that patients whose immune systems were already fighting the cancer had greater tumor death before surgery, suggesting the immunotherapy revved up the immune response to the cancer. To measure that increased immune response, the researchers used new method of profiling the immune response to the immunotherapy, called TARGET, which was developed by a collaboration of researchers and clinicians. It provides a much more detailed view of tumor response using serial biopsies, stool samples and blood analysis.
The research team is continuing to follow the patients in this study to see if greater tumor death ultimately results in better outcomes.
Sources: Mount Sinai press release and The Lancet Gastroenterology & Hepatology.
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