Opdivo-Yervoy Combo Showing Efficacy in Aggressive Prostate Cancer Patients with Select Mutations

Opdivo-Yervoy Combo Showing Efficacy in Aggressive Prostate Cancer Patients with Select Mutations
A combination of two approved immunotherapies — Opdivo (nivolumab) and Yervoy (ipilimumab) — appears to delay cancer progression and lengthen survival in a subset of patients with an aggressive form of castration-resistant prostate cancer, results from an ongoing pilot trial led by Johns Hopkins School of Medicine show. The study, “Ipilimumab plus nivolumab and DNA-repair defects in AR-V7-expressing metastatic prostate cancer,” was published in the journal Oncotarget. It targeted patients with AR-V7-positive prostate cancer — tumors that produce a variant of the androgen receptor that is resistant to current hormone therapies. These patients generally have a median overall survival of seven to nine months. This type of prostate cancer was first discovered by a Johns Hopkins-led team of researchers in 2014.  The pilot trial (NCT02601014), led by a scientist involved in that earlier work, examined if a combination of two immune checkpoint inhibitors — Yervoy and Opdivo — could be of some benefit to patients with this type of cancer.  Based on positive preliminary findings, the trial has been expanded and is actively recruiting patients at its Maryland site. Fifteen people were enrolled and treated with an intravenous infusion of Yervoy and Opdivo every three weeks for a total of 12 weeks (four doses), followed by a maintenance regimen of Opdivo every two weeks for up to 36 weeks. Among eight patients with measurable tumors, one-quarter of them — or two people — had partly or completely reduced tumors, the study reports. But only patients whose tumors had mutations in genes involved in DNA repair, including mutations at the BRCA2, ATM or ERCC4 genes, benefitted from this treatment approach. "This finding is imp
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