News in brief: Aussie oncologists present at ASCO 2021; Checkpoint inhibition promise in bladder cancer; New Zostavax warnings for immunocompromised patients

3 Jun 2021

ASCO 2021 to feature Australian trial results

Australian oncologists will be among thousands of  participants in the world’s largest cancer scientific meeting when the ASCO 2021 conference begins on Friday 4 June. The meeting will be all virtual, and will include presentations from Professor Georgina Long of the University of Sydney, who will report ‘breakthrough’ results from a trial of relatlimab, targeting the LAG-3 protein in melanoma.

According to Professor Long, findings from the RELATIVITY-047 trial showed that in previously untreated advanced melanoma patients, combining relatlimab with nivolumab doubled the progression free survival time compared to the use of nivolumab alone (10.1 vs 4.6 months respectively).

At one year, almost 50% of patients on the combination therapy had no disease progression, whereas nearly two-thirds of patients on the single therapy had progressed.

Checkpoint inhibitor option for hard to treat bladder cancer

Pembrolizumab monotherapy has shown promising antitumour activity in patients with BCG-unresponsive non-muscle-invasive bladder cancer who declined or were ineligible for radical cystectomy.

Cohort A of the phase 2 KEYNOTE-057 study comprised 101 patients assigned to pembrolizumab 200 mg intravenously every 3 weeks for up to 24 months.

The study found 41% of the group had a complete response at three months.

The treatment was considered tolerable with grade 3 or 4 treatment-related adverse events, including arthralgia and hyponatraemia, in 13% of patients.

The study concluded that pembrolizumab should be considered a clinically active non-surgical treatment option in a difficult-to-treat population.

The Lancet Oncology

More warnings on Zostavax for immunosuppressed patients

The TGA has revealed the wording of new warnings for Zostavax vaccine to address the risk of fatal disseminated varicella-zoster virus infection in immunocompromised patients.

A new boxed warning has been added to the Product Information (PI) with information about managing this risk, including pre-screening and risk-based assessment prior to use of the vaccine, and management of suspected cases.

The warning states there have been several fatal cases of disseminated vaccine-related VZV infection in Australia, including in patients on low dose immunosuppressive medication, and that the risk increases with the degree of immunosuppression.

It advises that the vaccine is contraindicated in patients with current or recent severe immunocompromising conditions from either a primary or acquired medical condition or medical treatment.

“Careful pre-screening and a risk-based assessment is required prior to administration of any dose of Zostavax. If appropriate, this assessment should include medical specialist consultation and potentially screening for pre-existing antibody to VZV. In such cases, vaccination should be deferred until such advice and/or results have been obtained,” it advises.

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