Mount Sinai Health System faculty will be presenting research updates on a lymphoma vaccine clinical trial, the best dosing for a drug against metastatic cancer, and new treatment strategies in relapsed multiple myeloma at the American Society of Clinical Oncology (ASCO) annual meeting, May 29 - June 2, 2015, in Chicago. ASCO is the world's largest oncology meeting, with more than 25,000 researchers presenting their latest study results.
Key abstract presentations include:
* In situ vaccine for low-grade lymphoma: Combination of intratumoral Flt3L and poly-ICLC with low-Dose radiotherapy.
Lymphomas are the 5th most incident cancer in the U.S. Low-grade non-Hodgkin's lymphomas are incurable with standard therapy. In three previous trials of 'in situ vaccination' - combining low-dose radiotherapy with administration of a TLR9 agonist directly into the tumor, researchers demonstrated remissions, some lasting years. In a newer iteration of this approach being studied in an ongoing clinical trial at Mount Sinai, a novel component has been added to recruit essential immune cells called 'dendritic cells' to the patient's tumor prior to administration of the TLR agonist. Preliminary results of this trial have shown patients achieving partial or complete clinical remissions, including patients with advanced stage disease. "TLR agonists work as immune cell stimulants to activate dendritic cells which are better at presenting antigens than any other cell types," said Joshua Brody, Director, Lymphoma Immunotherapy Program, Assistant professor of Medicine, Hematology, and Medical Oncology, Icahn School of Medicine at Mount Sinai. "This is the first vaccine that is administered directly into the tumor or in situ. We are training the immune system to fight cancer and the results we are seeing are very exciting. We hope to continue to see long-term remission in our patients."
Ajai Chari, MD, Associate Professor, Medicine, Hematology and Medical Oncology, Icahn School of Medicine, and Sundar Jagannath, MD, Director of the Multiple Myeloma Program at Tisch Cancer Institute at Mount Sinai and Professor of Hematology and Medical Oncology, Icahn School of Medicine will present results from a Phase 2 clinical trial of the novel HDAC inhibitor panobinostat in combination with lenalidomide and dexamethasone as an effective strategy for treatment resistant multiple myeloma (MM). Previous clinical trials of panobinostat in combination with bortezomib and dexamethasone have been effective but associated with increase gastrointestinal toxicity. "Our primary objective was to find the best overall response rate using a new dosing method," said Dr. Chari. "We found impressive and durable responses even in lenalidomide refractory myeloma patients without gastrointestinal toxicity."
* A randomized phase III study of standard vs. longer interval dosing of zoledronic acid in metastatic cancer.
Charles Shapiro, MD, Director of Translational Breast Cancer Research at the Tisch Cancer Institute at Mount Sinai and Professor of Medicine at the Icahn School of Medicine at Mount Sinai will present findings from a large multi-institutional trial of zoledronic acid intravenously for patients with breast, prostate and multiple myeloma cancer. 1,800 patients were given zoledronic acid every three months, for a total of eight doses versus the standard 24 monthly treatment. "This study proved to be a changing practice in treatment for patients with breast, prostate and multiple myeloma with skeletal metastases," said Dr. Shapiro. "The eight doses of zoledronic acid given over a two-year period provided comparable efficacy compared to the 24 monthly dosing in the reduction of skeletal related events such as pain, fractures, radiation to the bone and surgery to the bone." According to Shapiro, the zoledronic acid given to patients every three months was not inferior to IV zoledronic acid given monthly and should be adopted as the new standard of care in treating patients with skeletal metastases. The treatment provided patients with fewer side effects and was associated with a lower cost.
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