Comment on drug developments in advanced melanoma
Dr Roy Herbst - Yale Cancer Center, New Haven, USA
I think that’s extraordinary because what we’re seeing now is that you can use the ipilimumab, which targets CTLA-4 which works a little bit earlier in the T-cell priming, but that will only work if there are T-cells there in the tumour. So basically by using GM-CSF you actually mobilise, I believe, more T-cells to the tumour. So I think combining approaches to get T-cells and the immune system mobilised and then to release the checkpoint really makes a lot of sense so I’m very positive about that.
Can you also comment on Dr Mario Sznol’s research?
I know this work well, Mario is one of my colleagues at Yale Cancer Center where we both work, and I can tell you that the results in melanoma are extraordinary and he’s updating results of a large trial first presented last year and now completed. It shows that the responses are continuing at the high rate and they’re durable and patients benefit, they feel better, tumours don’t progress. So I think we really have a new paradigm in how we’re looking at cancer therapy.
How optimistic can doctors be about these targeted therapies?
I think that we should be very optimistic. These agents are already moving to phase III and the results we see are all quite intriguing, quite exciting. I think now the next step will be to try to understand who responds and why but also who doesn’t respond and look at those tumours and understand ways that we could then enhance the immune response, enhance the immune system, such as with GM-CSF and other things, to make things even better. So the sky’s the limit here; if the era of personalised medicine ever needed a new champion I think the immune therapy is one because it’s going to allow us to really take an agent that works in a lot of patients but doesn’t work in everyone and figure out how to really hone it in, how to combine it and to do it in personalised ways with tissue biopsies looking at T-cells, looking at how T-cells activate. So I’m very excited to be part of this journey.