A vision of immuno-oncology: the Siena think tank of the Italian network for tumor biotherapy (NIBIT) foundation

Our plain-English summary of A vision of immuno-oncology: the Siena think tank of the Italian network for tumor biotherapy (NIBIT) foundation, by M. Maio, M. Lahn, A.M. Di Giacomo, et al (Journal of Experimental & Clinical Cancer Research, 2021).

The study

• Authors: M. Maio, M. Lahn, A.M. Di Giacomo, A. Covre, L. Calabrò, R. Ibrahim, B. Fox, T.A.N.K. Siena Think
• Journal: Journal of Experimental & Clinical Cancer Research
• Published: 2021;40(1):240
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The yearly Think Tank Meeting of the Italian Network for Tumor Biotherapy (NIBIT) Foundation, brings together in Siena, Tuscany (Italy), experts in immuno-oncology to review the learnings from current immunotherapy treatments, and to propose new pre-clinical and clinical investigations in selected research areas. MAIN: While immunotherapies in non-small cell lung cancer and melanoma led to practice changing therapies, the same therapies had only modest benefit for patients with other malignancies, such as mesothelioma and glioblastoma. One way to improve on current immunotherapies is to alter the sequence of each combination agent. Matching the immunotherapy to the host's immune response may thus improve the activity of the current treatments. A second approach is to combine current immunotherapies with novel agents targeting complementary mechanisms. Identifying the appropriate novel agents may require different approaches than the traditional laboratory-based discovery work. For example, artificial intelligence-based research may help focusing the search for innovative and most promising combination partners.

Conclusion: Novel immunotherapies are needed in cancer patients with resistance to or relapse after current immunotherapeutic drugs. Such new treatments may include targeted agents or monoclonal antibodies to overcome the immune-suppressive tumor microenvironment. The mode of combining the novel treatments, including vaccines, needs to be matched to the patient's immune status for achieving the maximum benefit. In this scenario, specific attention should be also paid nowadays to the immune intersection between COVID-19 and cancer.

© 2021. The Author(s).

In plain English

This article was a meeting report, not a new study. The authors summarized presentations and working group discussions from the 2018, 2019 and 2020 Think Tank meetings of the Italian Network for Tumor Biotherapy (NIBIT) Foundation in Siena, Italy. The report reviewed published and ongoing research on cancer immunotherapy in non-small cell lung cancer, melanoma, mesothelioma and glioblastoma. It also covered epigenetic drugs, vaccines, artificial intelligence and COVID-19. It did not discuss asbestos and presented no new patient data. For mesothelioma, it described earlier trials, some of which involved authors of this report. A trial of tremelimumab alone (DETERMINE) showed no survival benefit over placebo. The NIBIT-MESO-1 study reported a median overall survival of 16.5 months. A phase III trial of first-line nivolumab plus ipilimumab reported a median overall survival of 18.1 months (95% confidence interval 16.8 to 21.4), against 14.1 months (12.4 to 16.2) for patients on conventional chemotherapy. The report said these results led to FDA approval of that combination as first-line therapy. The authors stated that combination therapies are the most likely path to improving the treatment of mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Meeting report (narrative summary of expert discussions and of published and ongoing studies); no original data
• Who was studied: Experts in immuno-oncology attending the 2018, 2019 and 2020 NIBIT Foundation Think Tank meetings in Siena, Italy; the report discussed studies in non-small cell lung cancer, melanoma, mesothelioma and glioblastoma
• Exposure: No asbestos or other exposure was studied; the report discussed cancer immunotherapy treatments
• Main results:
  • Reported from an earlier trial (DETERMINE, cited as reference 42, whose authors include report authors Maio and Calabrò): in second-line mesothelioma, single-agent tremelimumab showed no survival benefit over placebo. The text calls it phase III, but reference 42 is titled a phase 2b trial
  • Reported from an earlier trial (NIBIT-MESO-1, a CTLA-4 plus PD-1/PD-L1 combination in mesothelioma, cited as reference 71, whose authors include report authors Calabrò and Covre): overall response rate 28%, disease control rate 65%, median overall survival 16.5 months
  • Reported from an earlier trial (INITIATE, nivolumab plus ipilimumab as second-line mesothelioma treatment): partial response in 29% (10/34) and stable disease in 38% (13/34)
  • Reported from an earlier trial (printed in the text as CheckMate 763, first-line nivolumab plus ipilimumab in mesothelioma): median overall survival 18.1 months (95% CI 16.8 to 21.4) versus 14.1 months (12.4 to 16.2) for patients receiving conventional chemotherapy; hazard ratio 0.74, 96.6% CI 0.60 to 0.9, p = 0.0020
  • The report stated that these results led to FDA approval of nivolumab plus ipilimumab as first-line therapy for mesothelioma
  • Reported from an earlier trial (PROMISE-Meso, second-line mesothelioma): median overall survival 10.7 months for pembrolizumab versus 11.7 months for gemcitabine or vinorelbine chemotherapy (p = 0.85)
• The authors' conclusion: The authors stated that, because mesothelioma grows aggressively, combination therapies are the most likely path to improving its treatment

Topics

Medical terms in this study, explained in our Lexicon: Immunotherapy, Non-Small Cell Lung Cancer, Mesothelioma, Discovery, Monoclonal Antibody, Tumor Microenvironment.

Related studies

• Tremelimumab combined with durvalumab in patients with mesothelioma (NIBIT-MESO-1): an open-label, non-randomised, phase 2 study — L. Calabrò, A. Morra, et al. (2018)
• Tremelimumab plus durvalumab retreatment and 4-year outcomes in patients with mesothelioma: a follow-up of the open label, non-randomised, phase 2 NIBIT-MESO-1 study — L. Calabrò, G. Rossi, et al. (2021)
• Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors — S. Hendry, R. Salgado, et al. (2017)
• Treat it or Leave it: Immuno-Oncology in Mesothelioma Observed by the Eyes of Argus — C.J. de Gooijer, P. Baas (2018)
• Circulating Levels of PD-L1 in Mesothelioma Patients from the NIBIT-MESO-1 Study: Correlation with Survival — C. Chiarucci, S. Cannito, et al. (2020)
• Treatment with tumor-treating fields (TTFields) suppresses intercellular tunneling nanotube formation in vitro and upregulates immuno-oncologic biomarkers in vivo in malignant mesothelioma — A. Sarkari, S. Korenfeld, et al. (2023)

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