Yvonne M. Saenger, MD, Assistant Professor in Medicine and Dermatology, Hematology and Medical Oncology, Mount Sinai School of Medicine, discusses the need for biomarkers for immunotherapies.

For a long time, immunotherapies were not effective at all, Saenger says. Now that effective immunotherapies exist, it is important to define which patients are most likely to see benefit. Additionally, it is important to define which patients will not likely see benefit, so that they can receive other treatments or different approaches.

In the case of ipilimumab (Yervoy) for melanoma, only about 5% of patients will see a long term response and 20% are alive at two years. Though the latest data suggest that 40% of patients may be alive at two years, this benefit is still not good enough, Saenger says. The oncology community hopes to develop agents that will help everyone and biomarkers that will help prioritize treatment for those most likely to see benefit.

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Dr. Saenger on the Need for Immunotherapy Biomarkers

Yvonne M. Saenger, MD, Assistant Professor in Medicine and Dermatology, Hematology and Medical Oncology, Mount Sinai School of Medicine, discusses the idea of combining targeted and immune agents.

It is very attractive to combine these two types of agents, Saenger says, as targeted agents knock down the tumor burden; however, they generally do not produce long term responses. Additionally, when a large tumor is present, a patient is less likely to respond to immunotherapy, as the tumor is generally immunosuppressive.

The concept behind the phase II CA184-240 study in advanced melanoma is to hit the tumor with vemurafenib, a BRAF inhibitor, then administer ipilimumab, an CTLA-4-targeted immunotherapy. However, unfortunately, a previous trial using these drugs simultaneously demonstrated liver toxicity.

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Yvonne M. Saenger, MD

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Dr. Saenger on the Need for Immunotherapy Biomarkers

Dr. Saenger on Combining Targeted and Immune Agents