Professor Coulie explains, at a cellular level, the mechanistic differences between immune and clinical responses to tumors. He discusses the clinical conundrum regarding knowing when a prolonged immune response is obtained in patients and when checkpoint inhibitors can be stopped. He highlights the importance of blockade of both CTLA-4 and PD-1. Professor Coulie explains the kinetics of clinical responses to immunostimulatory antibodies and that immediate and delayed clinical responses can be observed in patients; this unpredictable phenomenon supports long duration checkpoint blockade.
In his presentation, Professor Neyns shows how immunotherapy has substantially improved long-term survival outcomes of metastatic melanoma patients. However the debate on how long to continue immunotherapy is still ongoing. The speaker discusses the available efficacy outcomes of patients included in clinical trials with an arbitrary treatment duration of 2 years, the findings of a real-world retrospective research across Europe and Australia, led by his team, looking at patients who stopped treatment in the absence of disease progression, the impact of stopping dual immunotherapy early on because of AEs. In the last section of the presentation, Prof Neyns discusses the results of a research evaluating the potential role of FDG-PET in predicting long-term outcomes.
Professor Vansteenkiste, though a patient case study discusses the treatment of NSCLC and the question of what to do (stop vs continue) if a patient does well on treatment with checkpoint blockade. He discusses the current guidelines as well as the clinical data on patients treated beyond 1 year as well as those treated up to 2 years and then rechallenged. Professor Vansteenkiste also discusses results from an exploratory analysis on the relevance of the depth of responses in terms of survival.
Many patients can experience a whole range of emotional concerns that arise after completing active treatment for cancer including the fear to stop the treatment. Cancer survivors may be experiencing anxiety, worry, sadness, fear of cancer recurrence and these symptoms can become worse after the end of the cancer treatment. Professor Rogiers starts her presentation with an illustrative patent case. Then she discusses the results of her own research investigating the emotional burden in advanced melanoma survivors including the emotional impact and Functional and Symptom Health related Quality of Life in long term melanoma survivors ≥ 6 months disease-free after start anti-PD1, comparing the results of the study population with the normative data of the European Mean.
Illustrative case on the role of local therapy in the management of solitary melanoma progression following elective discontinuation of anti-PD-1 therapy in a BRAF V600 mutated melanoma patient
Professor Vansteenkiste, though a patient case study discusses oligoprogressive disease of NSCLC and the role of local ablative treatment. He provides an overview of the clinical studies that have investigated the combination of I-O and radiotherapy.