Eric Whitman, MD, medical director of Atlantic Health System Cancer Care, Atlantic Health System, discusses ways to expand the benefit of immunotherapy in nonimmunogenic solid tumors.

At Morristown Medical Center’s 7th Annual Joseph Calello Melanoma Scholar presentation, Adil Daud, MD, of the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discussed ways to turn “cold” tumors into “hot” tumors. Atlantic Health System is conducting several trials looking at the role of interleukin (IL)-12 in increasing the immunogenicity of a tumor. In these trials, patients who have failed multiple lines of therapy are treated with anti—PD-1 agents and IL-12 via electroporation.

Other ongoing work is assessing T cell response to immunotherapy. In the cases of “cold” tumors, researchers believe the T cells become exhausted and are unable to generate an immune response. If researchers can use IL-12 to reactivate the T cells remains to be seen, Whitman concludes.

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Eric Whitman, MD, medical director of Atlantic Health System Cancer Care, Atlantic Health System, discusses ways to expand the benefit of immunotherapy in non-immunogenic solid tumors.

Dr. Whitman on Expanding the Benefit of Immunotherapy in Solid Tumors

Eric Whitman, MD, medical director of Atlantic Health System Cancer Care, Atlantic Health System, discusses eliminating financial toxicity in oncology.

The goal of being an oncologist is to provide the best cancer care to patients, explains Whitman. That includes access to the newest therapies and the newest technologies. In addition to these facets of cancer care, Whitman explains that the last variable is affordability.

On October 4 2018, Atlantic Health System announced The Breakthrough Oncology Accelerator flagship program, in which Atlantic Health will partner with the Translational Genomics Research Institute (TGen) and Origin Commercial Ventures to develop a new platform to ensure economically accessible immunotherapies and other prominent cancer therapies to the region. It is through Atlantic Health System’s partnership with Origin and TGen that they hope to bridge this gap in accessibility and increase the rate of cure, says Whitman.

Dr. Whitman on Eliminating Financial Toxicity in Oncology

Eric Whitman, MD, medical director of Atlantic Health System Cancer Care, Atlantic Health System, discusses improving precision medicine in oncology.

Physicians have to do a better job of classifying patients upfront, says Whitman. Whitman believes this will come from better understanding of the genetics of the tumor and the immune system as well as their overall interaction. This will enable physicians to make the best treatment decisions, says Whitman.

As part of Atlantic Health’s partnership with Origin and TGen, physicians are going to leverage the laboratory and technical abilities of TGen to identify the patients who should be treated and those who should avoid a specific therapy. Additionally, physicians have to be able to monitor a patient beyond what the size of their lesion is on their CAT scan. This may be through subtle changes in a patient’s immune system that can be identified through testing of the tumor. This will manifest in more efficient means of identifying whether a therapy is working or not, says Whitman.

Dr. Whitman on Improving Precision Medicine in Oncology

Eric Whitman, MD, medical director of Atlantic Health System Cancer Care, Atlantic Health System, discusses the partnership between Atlantic Health System, Translational Genomics Research Institute (TGen), and Origin Commercial Ventures.

On October 4 2018, Atlantic Health System announced a partnership with the Translational Genomics Research Institute and Origin Commercial Ventures to create a new platform to deliver economically accessible immunotherapies and other prominent cancer therapies to the region.

The goal behind the partnership, says Whitman, is to improve the drug pipeline, so that physicians at Atlantic Health have local access to the best therapies and technologies for patients. Community oncologists are very excited by the partnership, explains Whitman, as it enables their patients to stay within the community. Traditionally, a patient who has expended all of their options is referred to a center that is far away. Now, a patient can be referred to a research center on site, enabling much better in-house communication.

Dr. Whitman on the Partnership Between Atlantic Health System, TGen and Origin

Eric Whitman, MD, surgeon, Atlantic Health System, discusses the role of pembrolizumab (Keytruda) in the treatment of patients with melanoma.

Being treated with pembrolizumab has provided a longer life for patients with melanoma, says Whitman. Previously, patients with metastatic melanoma would be put on clinical trials, but the outcomes were not successful. However, now with the addition of pembrolizumab, patients seem to be doing quite well, Whitman adds.

There are many toxicities that are intrinsic to treatment with pembrolizumab. Physicians are often used to chemotherapy-related toxicities, such as hair loss or tongue swelling, but toxicities associated with immunotherapy are different, explains Whitman. Since these drugs affect the immune system, the side effects are mostly autoimmune-related.

In the phase III EORTC1325/KEYNOTE-054 trial, adjuvant pembrolizumab reduced the risk of recurrence by 43% in patients with stage III resected high-risk melanoma. The hazard ratio for recurrence-free survival was 0.57 for pembrolizumab versus placebo (98.4% CI, 0.43-0.74; 

 <.0001). There were no new safety concerns in the KEYNOTE-054 trial compared with outcomes reported in previous studies of the PD-1 inhibitor.

Eric Whitman, MD

Articles

Dr. Whitman on Expanding the Benefit of Immunotherapy in Solid Tumors

Dr. Whitman on Eliminating Financial Toxicity in Oncology

Dr. Whitman on Improving Precision Medicine in Oncology

Dr. Whitman on the Partnership Between Atlantic Health System, TGen and Origin

Dr. Whitman on the Role of Pembrolizumab in Melanoma