Lawrence Fong, MD, Professor, Department of Medicine (Hematology/Oncology), University of California San Francisco, discusses the importance of educating oncologists on the side effects of immunotherapies.

Immunotherapies have side effects that are different than the conventional chemotherapies or targeted therapies that oncologists are accustomed to, says Fong. One of the biggest challenges, now that immunotherapies are becoming more common, has been to education all oncologists on these side effects and how to treat them, he adds.

If recognized early, the side effects of immunotherapies are very treatable and manageable, says Fong.

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Dr. Lawrence Fong on Managing the Side Effects of Immunotherapies

Lawrence Fong, MD, associate professor, Department of Medicine (Hematology/Oncology), University of California, San Francisco, discusses the systemic antitumor effect and clinical response in a phase II trial of intratumoral electroporation of plasmid interleukin-12 (IL-12) in patients with advanced melanoma.

Fong says rather than trying to use an vaccine to induce an immune response, researchers attempted to utilize the patient’s own tumor as a vaccine. In this study, a DNA plasmid was injected into the tumor site and then electrodes were placed into the tumor site to introduce the injected DNA into the tumor microenvironment.

The injected plasmid expresses IL-12, Fong says, which is one of the critical cytokines that help teach T cells to recognize antigens. The study found that when this cytokine was introduced to tumors in patients with metastatic melanoma, responses are seen not only in the site of injection, but also at distant tumor sites. Fong says this is consistent with the idea that an immune response is being activated that can circulate and impact cancer at other sites.

This trial is now being expanded based upon these results, Fong says. Researchers hope to further understand the mechanics of this interaction.

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Lawrence Fong, MD, from the University of California, San Francisco, discusses the systemic antitumor effect and clinical response in a phase II trial of intratumoral electroporation of plasmid interleukin-12 in patients with advanced melanoma.

Dr. Fong Discusses Intratumoral Electroporation of Plasmid IL-12 in Melanoma

Lawrence Fong, MD, associate professor, Department of Medicine (Hematology/Oncology), University of California, San Francisco, explains that not understanding the mechanism of action for the various immunotherapies is one of the greatest challenges facing the field.

In order to gauge the immune response, a trial was conducted that administered the immunotherapy sipuleucel-T (Provenge) prior to prostatectomy. Once the prostate was removed, the trial examined the immune response in the tissue in order to assess the degree of activity. An increase in T cells was observed within the prostate and specifically around the edges of the tumor, Fong notes. Additionally, an immune response was linked directly to the target antigens used by sipuleucel-T.

Fong believes this trial provides further insight into the mechanism of action of immunotherapies. The next step for these trials is to investigate how the T cells affect the tumors and the degree of clinical activity.

Dr. Lawrence Fong from University of California, San Francisco, Discusses Immune Response to Sipuleucel-T

Lawrence Fong, MD

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Dr. Lawrence Fong on Managing the Side Effects of Immunotherapies

Dr. Fong Discusses Intratumoral Electroporation of Plasmid IL-12 in Melanoma

Dr. Fong Discusses Immune Response to Sipuleucel-T