Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

5031 - Pilot Study: Localizing target lymph node using a magnetic marker allows reliable and representative judgement of pathological responses after neo-adjuvant Ipilimumab (IPI) + Nivolumab (NIVO) in macroscopic stage III melanoma

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Alexander van Akkooi

Citation

Annals of Oncology (2018) 29 (suppl_8): viii442-viii466. 10.1093/annonc/mdy289

Authors

A.C.J. van Akkooi1, B. Schermers2, V. Franke1, M. Wouters1, C.L. Zuur3, W.M.C. Klop3, E.A. Rozeman4, B.A. van de Wiel5, T.J.M. Ruers1, C.U. Blank6

Author affiliations

  • 1 Surgical oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 2 Surgical oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX - Amsterdam/NL
  • 3 Head And Neck Surgery And Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 4 Medical Oncology, The Netherlands Cancer Institute, 1066 CX - Amsterdam/NL
  • 5 Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 6 Medical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX - Amsterdam/NL
More

Resources

Abstract 5031

Background

The outcome of high risk stage III melanoma patients (pts) is poor, with a 5-year overall survival (OS) rate of < 50%. Adjuvant (adj) high dose IPI , adj NIVO and pembrolizumab improved RFS. Neo-adjuvant (neoadj) treatment may be an even more favorable approach as immune checkpoint inhibition is of greatest value at the moment of TCR triggering and therefore dependent on the amount of antigen present. In our previous phase Ib OpACIN study the pathological RR (pRR) was 78% in the neoadj arm, and to date after 25 months of median follow-up none of the responders has relapsed. This raises the question whether such pts need to undergo complete lymph node dissection (CLND). A prerequisite for such an approach would be an analysis method that reliably indicates pathological response within the whole lymph node bed, without the need for CLND.

Methods

To address this question an in-house developed magnetic marker was placed ultrasound-guided at baseline into the largest regional lymph node metastasis of pts participating in OpACIN-neo, (NCT02977052), a phase 2 trial aiming at identification of the optimal neoadj combination scheme of IPI and NIVO in stage IIIB/C melanoma pts followed by CLND.

Results

So far, 11 pts participated in this side trial of OpACIN-neo. No complications from marker placing were observed, and all magnetic markers were retrieved during the CLND after 6 weeks of neoadj IPI+NIVO. 10/11 marked lymph-nodes (LN were representative in their response for the whole CLND specimen, i.e. index node showed a complete or partial response (PR), all others on CLND showed the same or better responses. Only 1 case was incongruent, as the index LN had 60% vital tumor (no response) compared to another LN (40% vital tumor, PR).

Conclusions

Our early exploratory data from this pilot study indicate that marked LN in stage III melanoma could serve as response indicators for the outcome of the whole CLND after neoadj IPI+NIVO. If confirmed, our data can open the path towards response-driven extent of lymph-node dissection in macroscopic stage III melanoma.

Clinical trial identification

NCT02977052.

Legal entity responsible for the study

Alexander C.J. van Akkooi.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

A.C.J. van Akkooi: Consulting or advisory: Amgen, Novartis, MSD Oncology, Merck; Travel, accommodations, expenses: Amgen, Roche, Novartis; Research funding: Amgen, Novartis. C.U. Blank: Personal fees, Advisory role: MSD, BMS, Roche, GSK, Novartis, Pfizer, Lilly; Grants: BMS, Novartis, outside the submitted work. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.