TAT 2018: Current challenges in evaluating and managing combination of immunotherapies

Speaker: Aurelien Marabelle

According to Aurelien Marabelle past history of oncology has shown that empirical development of drugs has worked and it will probably be the best way to evaluate combinations of immunotherapies.

The combinations that are tested now in the clinic have as a background  a plenty of scientific rationale that have been published over the last 15 years in very good scientific journals. We need to see if murine data can be translated into human and learn about synergistic activity of combinations in one tumour indication and then expand testing across different tumour types.
Currently, testing of double combinations is ongoing in the clinic but we need to prepare for efficient and safe testing of triple combinations in order to have more patients responding to immunotherapy.
The key messages for the oncology community are that first, we need to keep up with the new data reported at a very fast pace. Second, new immunotherapy drugs are generating new toxicities and everyone needs to make sure that is following the patients correctly, so that they will not develop immune-related adverse events or hyper-progression of the disease. We will have to monitor patients in a different way than for conventional therapies and this requires cooperation with organ specialists and local efforts in every hospital in order to elaborate and have prepared plan when the patient develops a new toxicity. Finally, in Europe, oncology community is running late in term of access to these novel therapies and the difference in access across countries is very high. The EMA approved some indications, but the reimbursement and access to the treatments in different European countries is not going at the same pace.