Immunodynamics: a cancer immunotherapy trials network review of immune monitoring in immuno-oncology clinical trials

Holbrook E Kohrt, Paul C Tumeh, Don Benson, Nina Bhardwaj, Joshua Brody, Silvia Formenti, Bernard A Fox, Jerome Galon, Carl H June, Michael Kalos, Ilan Kirsch, Thomas Kleen, Guido Kroemer, Lewis Lanier, Ron Levy, H Kim Lyerly, Holden Maecker, Aurelien Marabelle, Jos Melenhorst, Jeffrey Miller, Ignacio Melero, Kunle Odunsi, Karolina Palucka, George Peoples, Antoni Ribas, Harlan Robins, William Robinson, Tito Serafini, Paul Sondel, Eric Vivier, Jeff Weber, Jedd Wolchok, Laurence Zitvogel, Mary L Disis, Martin A Cheever, Cancer Immunotherapy Trials Network (CITN), Holbrook E Kohrt, Paul C Tumeh, Don Benson, Nina Bhardwaj, Joshua Brody, Silvia Formenti, Bernard A Fox, Jerome Galon, Carl H June, Michael Kalos, Ilan Kirsch, Thomas Kleen, Guido Kroemer, Lewis Lanier, Ron Levy, H Kim Lyerly, Holden Maecker, Aurelien Marabelle, Jos Melenhorst, Jeffrey Miller, Ignacio Melero, Kunle Odunsi, Karolina Palucka, George Peoples, Antoni Ribas, Harlan Robins, William Robinson, Tito Serafini, Paul Sondel, Eric Vivier, Jeff Weber, Jedd Wolchok, Laurence Zitvogel, Mary L Disis, Martin A Cheever, Cancer Immunotherapy Trials Network (CITN)

Abstract

The efficacy of PD-1/PD-L1 targeted therapies in addition to anti-CTLA-4 solidifies immunotherapy as a modality to add to the anticancer arsenal. Despite raising the bar of clinical efficacy, immunologically targeted agents raise new challenges to conventional drug development paradigms by highlighting the limited relevance of assessing standard pharmacokinetics (PK) and pharmacodynamics (PD). Specifically, systemic and intratumoral immune effects have not consistently correlated with standard relationships between systemic dose, toxicity, and efficacy for cytotoxic therapies. Hence, PK and PD paradigms remain inadequate to guide the selection of doses and schedules, both starting and recommended Phase 2 for immunotherapies. The promise of harnessing the immune response against cancer must also be considered in light of unique and potentially serious toxicities. Refining immune endpoints to better inform clinical trial design represents a high priority challenge. The Cancer Immunotherapy Trials Network investigators review the immunodynamic effects of specific classes of immunotherapeutic agents to focus immune assessment modalities and sites, both systemic and importantly intratumoral, which are critical to the success of the rapidly growing field of immuno-oncology.

Keywords: Biomarker; Clinical trial; Immunotherapy.

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Source: PubMed

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