The trial you mention, NCT02060188, CheckMate142 is not just Nivolumab for MSS (that would have little chances to work: nivolumab monotherapy works well for most MSI-H, but not on itself for MSS). The trial proposed *combinations* of drugs.
It has TWO arms for MSS --that is non MSI-High-- colorectal cancer:
- Cohort C4: Nivolumab (Nivo) + Ipilimumab (Ipi) + Cobimetinib: one immunotherapy (nivolumab, brand name Opdivo, FDA approved for other cancers; an anti-PD-1) + ipilimumab (other immunotherapy, brand name Yervoy, FDA approved for melanoma; anti CTLA-4) + a MEK inhibitor (cobimetinib, brand name Cotellic, FDA approved against melanoma; a pill)
- Cohort C6: Nivolumab + Daratumumab . Daratumumab is an anti-CD38 monoclonal antibody (FDA approved for multiple myeloma, trade name Darzalex).
This first confirmed responses for immuntherapy, leaving aside the TIL trial at Bethesda, came from the combination of a checkpoint inhibitor (an anti PD-L1, that one might think equivalent of anti -PD-1 nivolumab or pembrolizumab) plus cobimetinib: http://meetinglibrary.asco.org/content/171295-176
Cobimetinib Plus Atezolizumab Active in Microsatellite Stable mCRC http://www.onclive.com/conference-cover ... table-mcrc
I do know someone from other group in this trial, who joined past January, is receiving the Nivo+Ipi+cobi combination, and reported past March that
CEA dropped by half and CT scan showed that some tumors shrank a bit! First time in nearly 2 years that scans did not show cancer growth.
Edited to add: this is an 'old' trial and the investigators changed the protocol past October to include cobimetinib --the arm 4-- and just one month ago to include the arm 6-- so that is why you won't find too much data about it yet, and nothing about arm 6. I think something is going to be published next June at ASCO annual meeting.
PeterG wrote:The trial you mention, NCT02060188, CheckMate142 is not just Nivolumab for MSS (that would have little chances to work: nivolumab monotherapy works well for most MSI-H, but not on itself for MSS). The trial proposed *combinations* of drugs.
It has TWO arms for MSS --that is non MSI-High-- colorectal cancer:
- Cohort C4: Nivolumab (Nivo) + Ipilimumab (Ipi) + Cobimetinib: one immunotherapy (nivolumab, brand name Opdivo, FDA approved for other cancers; an anti-PD-1) + ipilimumab (other immunotherapy, brand name Yervoy, FDA approved for melanoma; anti CTLA-4) + a MEK inhibitor (cobimetinib, brand name Cotellic, FDA approved against melanoma; a pill)
- Cohort C6: Nivolumab + Daratumumab . Daratumumab is an anti-CD38 monoclonal antibody (FDA approved for multiple myeloma, trade name Darzalex).
This first confirmed responses for immuntherapy, leaving aside the TIL trial at Bethesda, came from the combination of a checkpoint inhibitor (an anti PD-L1, that one might think equivalent of anti -PD-1 nivolumab or pembrolizumab) plus cobimetinib: http://meetinglibrary.asco.org/content/171295-176
Cobimetinib Plus Atezolizumab Active in Microsatellite Stable mCRC http://www.onclive.com/conference-cover ... table-mcrc
I do know someone from other group in this trial, who joined past January, is receiving the Nivo+Ipi+cobi combination, and reported past March that
CEA dropped by half and CT scan showed that some tumors shrank a bit! First time in nearly 2 years that scans did not show cancer growth.
Edited to add: this is an 'old' trial and the investigators changed the protocol past October to include cobimetinib --the arm 4-- and just one month ago to include the arm 6-- so that is why you won't find too much data about it yet, and nothing about arm 6. I think something is going to be published next June at ASCO annual meeting.
Thanks Maia--I had seen that it was a "cocktail" but had been quite inarticulate in my posting, upon reflection. (And I had read it as Cohort 6 only for MSS, but again, generally hasn't been my wheelhouse.) By paper next June, do you mean June 2017? I suppose I am grasping at straws--we all are, to some degree--hoping that, as an MSS patient, I can be treated with checkpoint inhibitors that might stand a chance, before my tumors kill me (I hope that doesn't sound overly melodramatic, because writing it that way sure did.) Apparently I am going to have problems not being eliminated from trials at this point, anyhow, because most trials require failure on folifiri or folofox--is this correct? What do you (or anyone) know about clinical trials with checkpoint inhibitors on MSS patients? Again, sorry for my unfamiliarity with the research, and potentially ignorant questions. I really do appreciate your insight!
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