“Cancer Immunotherapy Insights from ASCO” Twitter Chat Recap #CIMchat

Coming just off the heels of the largest clinical oncology meeting in the world, the annual meeting of the American Society of Clinical Oncology (ASCO), which took place last week in Chicago, the Cancer Research Institute hosted a Twitter chat on Tuesday, June 11, to discuss the latest immunotherapy news to come out of the conference and what it means for cancer patient treatment.

Moderated by Sharon Begley (@sxbegle), senior science writer at STAT (@statnews), the chat attracted more than 30 participants including oncologists, scientists, and other cancer professionals representing some of the most prestigious research and cancer treatment organizations. Our CEO and director of scientific affairs, Dr. Jill O’Donnell-Tormey, took over the CRI Twitter handle and joined in the lively discussion. Within the hour, participants chimed in with more than 190 posts in response to questions from our moderator on six key topics facing the field of immuno-oncology.

If you weren’t able to join the #CIMchat, here are some highlights:

Q1 Top I-O Highlights: What do you consider the most promising immunotherapy news out of #ASCO19 this year and why?

The opening question prompted numerous responses, including an insightful tweet from Dr. Kristen Mueller of the Melanoma Research Alliance (@MelanomaReAlli):

A1: We’re excited about #TIL, that is tumor-infiltrating lymphocytes, as therapy for melanoma. #Iovance reported a 38% response rate in patients who have previously failed anti-PD1 with #lifileucel, their autologous TIL therapy. #CIMchat

— Melanoma Research (@MelanomaReAlli) June 11, 2019

Tumor immunologist and cancer biologist, Dr. Saman Maleki (@SMImmunology) of Schulich School of Medicine, shared his thoughts on tailoring treatment for each patient:

I agree. We need to find ways to transform the unresponsive tumor microenvironment for the consequent IO. This really means tailoring treatment for each patient that requires understanding of tumor's genomic make up and immune profile #CIMchat

— Saman Maleki, PhD (@SMImmunology) June 11, 2019

Q2 Checkpoint Blockade: How much more can we squeeze out of PD-1/L1 checkpoint blockade and what’s next on the horizon?

Ludwig Cancer Research’s (@ludwig_cancer) Dr. Ping-Chih Ho of Lausanne tweeted that there’s more coming down the road, especially in combination with other therapies:

A2: We are still far away from the end. Combined treatments with scientific rationale, such as Braf and MEK inhibition and Treg targeting, may be the next horizon. – Ludwig Lausanne’s Ping-Chih Ho @HolabUnil #CIMchat https://t.co/fLWibbmV6f

— Ludwig Cancer (@Ludwig_Cancer) June 11, 2019

Dr. Jason Luke (@jasonlukemd) of UPMC (@UPMC) shared that he doesn’t believe that PD-1 is the end-all, be-all of cancer immunotherapy:

Not sure we have to be beholden to the PD1 axis as the backbone in the way we used to think. The interesting data from #immunoonc19 for TLR7/8 + peg-IL2 suggested potential for response wo PD1. #CIMchat

— Jason Luke, MD, FACP (@jasonlukemd) June 11, 2019

Parker Institute for Cancer Imunotherapy (@ParkerICI) shared promising data for combination therapy including checkpoint blockade from AACR earlier this year.

Q2. Re: promising IO combos – a combination of anti-CD-40, anti-PD-1 & chemo shrank tumors in metastatic #pancreaticcancer patients in our Phase 1 study w/ @PennCancer, @BMSnews, Apexigen, @CancerResearch #CIMchat https://t.co/Gr39QRkFC1

— Parker Institute (@parkerici) June 11, 2019

Q3 Cellular Therapies: Are we any closer to treating solid tumors, what challenges remain, and what’s needed to overcome them?

Dr. Jill O’Donnell-Tormey of the @CancerResearch Institute recalled some exciting news from ASCO for cervical cancer patients:

A3 Perhaps most promising were #ASCO19 were TILs in cervical cancer, which led to responses in roughly half of patients and helped stabilize disease in most others. – JOT #CIMchat #CIM19 (1/2)

— Cancer Research Institute (@CancerResearch) June 11, 2019

Dr. Miguel Foronda of Weill Cornell remarked on the progress being made in mesothioma and other solid tumors:

A3: This is an interesting one! We are closer than ever with mesothelin CAR-Ts for mesothelioma @sloan_kettering and the IL13Rα2 CAR-Ts @cityofhope GBM trials to get effective CAR-T therapies for solid tumors. Hopefully more examples to come soon! #CIMchat #ASCO19 pic.twitter.com/s238ZrVSBo

— Miguel Foronda (@krknrm) June 11, 2019

Q4 Biomarkers: Why are they important and how are we finding ones that really matter?

Dr. Adam Stern (@AdamnPhilipStern) tweeted about a big difference he sees in how biomarkers are embraced on the research side versus the clinical:

A4: It seems like it's a tale of two biomarker cities. In the research world, biomarkers are beginning to take off and thrive. In the clinic, it's more of a snail's pace for adoption that changes management. #CIMchat #ASCO19

— Adam Stern, MD (@AdamPhilipStern) June 11, 2019

Dr. Corrie Painter of the Broad Institute at MIT made a plea for deeper immunology in patient trials:

A4 A plea from a scientist: add so many correlatives to your IO trials so that we can build a large repertoire of data to move toward better biomarkers and subsequent adoption in clinical practice #cimchat

— Corrie Painter, PhD (@corrie_painter) June 11, 2019

Q5 Responders v. Non-Responders: What are the more promising approaches to helping patients who don’t respond to initial I-O treatment?

Dr. Miguel Foronda (@krknrm) of Weill Cornell Medicine (@WeillCornell) tweeted an infographic published in Nature Reviews Cancer about exceptional responders and non-responders:

A5: We have a lot to learn from non-responders, to start with. There was a great review recently @NatureRevCancer about exceptional responders (for good or bad), all of which can teach us some biology (the paper –> https://t.co/cE3Nqg8Vnl ) #CIMchat #ASCO19 pic.twitter.com/a7BrSMANCT

— Miguel Foronda (@krknrm) June 11, 2019

Dr. Christopher Heery, chief medical officer at Precision Biosciences, pointed out that addressing key features in non-responders might help:

A5 For most tumors, this is the majority of patients. Usually, there is one of the following:
– lack of T cell response to tumor
– TME suppression of infiltration or function of T cells
Agents that address 1 or both of these may help. Biomarkers may help identify which. #cimchat https://t.co/G5l209JkNf

— Christopher Heery MD (@ChrisHeery) June 11, 2019

Q6 Survival: What have we learned about durability of benefit from several long-term survival data readouts at #ASCO19?  

Dr. Kristen Mueller of the Melanoma Research Alliance tweeted historic decline in death rates in melanoma thanks in large part to immunotherapy:

A6: We're finally starting to see a decline in the death rates from melanoma – likely due in large part to use of IO. The Annual SEER Report showed an 8.5% decline in the death rate per year from 2014 to 2016 in men & a 6.3% decline per year from 2013 to 2016 in women. #CIMchat

— Melanoma Research (@MelanomaReAlli) June 11, 2019

Dr. Jill O’Donnell-Tormey pointed to the impressive long-term survival data in lung cancer patients with her tweet from @CancerResearch:

A6 At #ASCO19 the five year survival rate for lung cancer patients treated with checkpoint inhibitors was approximately 25% and rose to 30% in patients with high PD-L1 expression. – JOT #CIMchat #CIM19

— Cancer Research Institute (@CancerResearch) June 11, 2019

Dr. Jason Luke of the University of Pittsburg Medical Center, reminded us that quality of life matters as much as quantity:

A6 #CIMchat Durability of response w #immunotherapy is KEY but quality of response matters also. @US_FDA had presentation #ASCO19 showing pts w major tumor shrinkage are those who go on to long term benefit. Maybe we should be more aggressive up front? https://t.co/1RVWEeXRFA

— Jason Luke, MD, FACP (@jasonlukemd) June 11, 2019

Our hour was up before we knew it. There’s a lot more to the conversation than we’ve shared here. We’ve curated more highlights with our #CIMchat Moment on Twitter here:

"Cancer Immunotherapy Insights from ASCO" #CIMchat

Special thanks, again, to our moderator, Sharon Begley (@sxbegle), and to our generous sponsor, Nektar Therapeutics (@NektarNews), for making today possible. Thank you, also, to all who participated!

Read our recap blogs for more insights from ASCO19 and participate in more Cancer Immunotherapy Month activities this June.