I went through the 200+ CRC abstracts released yesterday ahead of the ASCO 2019 annual meeting. I thought the following three abstracts were the most interesting and thought I’d share:
A phase I study of PolyPEPI1018 vaccine plus maintenance therapy in patients with metastatic colorectal cancer with a predictive biomarker (OBERTO).
https://meetinglibrary.asco.org/record/171761/abstract
Very interesting, but very early (only 2 responders). Hopefully there will be updated data within 12 months. I would think this will be also paired with checkpoint blockade. Clinicaltrial.gov says this trial is still recruiting, if anyone pursues this trial please let me know.
A phase II study of ipilimumab and nivolumab with radiation in microsatellite stable (MSS) metastatic colorectal adenocarcinoma (mCRC).
https://meetinglibrary.asco.org/record/171193/abstract
Seems like a tough treatment - but likely worthwhile if it can elicit a durable response. What’s interesting is that disease control was defined as control outside of the radiation field. So I guess this means RT was sensitizing the immune system so that immunotherapy works even on tumors not irradiated. It’s not clear to me if they are using SBRT or just normal RT. If it’s SBRT it’s probably well tolerated.
CCTG CO.26: Updated analysis and impact of plasma-detected microsatellite stability (MSS) and tumor mutation burden (TMB) in a phase II trial of durvalumab (D) plus tremelimumab (T) and best supportive care (BSC) versus BSC alone in patients (pts) with refractory metastatic colorectal carcinoma (rmCRC).
https://meetinglibrary.asco.org/record/171174/abstract
This forum had discussions about immunotherapy for MSS CRC with high TMB. This abstract sheds some light on the topic.