Ashani Weeraratna, Ph.D. The Ira Brind professor and Co-program leader of the Immunology, Microenvironment and Metastasis Program The Wistar Institute Member of Wistar’s Melanoma Research Center Philadelphia 

Anti-PD1 Immunotherapy May Work Better in Older Melanoma Patients

MedicalResearch.com Interview with:

Ashani Weeraratna, Ph.D. The Ira Brind professor and  Co-program leader of the Immunology, Microenvironment and Metastasis Program  The Wistar Institute Member of Wistar’s Melanoma Research Center Philadelphia 

Dr. Weeraratna

Ashani Weeraratna, Ph.D.
The Ira Brind professor and
Co-program leader of the Immunology, Microenvironment and Metastasis Program
The Wistar Institute
Member of Wistar’s Melanoma Research Center
Philadelphia 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response:  This study shows for the first time that older patients, especially those who have had prior MAPKi therapy fare better than younger patients when treated with anti-PD1. We found that tumors in younger patients and younger mice have higher levels of Tregulatory cells, the cells that regulate other immune cells. This is not true systemically, only within the tumor microenvironment.

We were surprised because we expected that, as with targeted therapy, older patients would have a poorer response to immunotherapy, given what we perceive as a poorer immune system in older patients. 

MedicalResearch.com: What should readers take away from your report?

Response: Age matters. Think about how patients in their 40’s and early 50’s might respond differently to those in their 60’s. In this case, in younger patients, combination therapies should perhaps be a first line option.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: There are drugs available that can target Tregs, and these drugs could potentially enhance immunotherapy effects. However, it is important to understand what the potential toxicities might be, and how to overcome those first.

MedicalResearch.com: Is there anything else you would like to add?

Response: I just want to point out that these data were gathered from all over the world, pointing to the truly global nature of our collaborations, and to that of the melanoma field in general. Disclosures include our lack of access to all of the variables that would allow us to do a multivariate analysis.

Citation:

Age Correlates with Response to Anti-PD1, Reflecting Age-Related Differences in Intratumoral Effector and Regulatory T-Cell Populations

Curtis H. Kugel III, Stephen M. Douglass, Marie R. Webster, Amanpreet Kaur, Qin Liu, Xiangfan Yin, Sarah A. Weiss, FarbodDarvishian, Rami N. Al-Rohil, Abibatou Ndoye, Reeti Behera, Gretchen M. Alicea, Brett L. Ecker, Mitchell Fane, Michael J.Allegrezza, Nikolaos Svoronos, Vinit Kumar, Daniel Y. Wang, Rajasekharan Somasundaram, Siwen Hu-Lieskovan, AlpaslanOzgun, Meenhard Herlyn, Jose R. Conejo-Garcia, Dmitry Gabrilovich, Erica L. Stone, Theodore S. Nowicki, Jeffrey Sosman, Rajat Rai, Matteo S. Carlino, Georgina V. Long, Richard Marais, Antoni Ribas, Zeynep Eroglu, Michael A. Davies, BastianSchilling, Dirk Schadendorf, Wei Xu, Ravi K. Amaravadi, Alexander M. Menzies, Jennifer L. McQuade, Douglas B. Johnson, Iman Osman and Ashani T. Weeraratna

Clin Cancer Res June 13 2018 DOI:10.1158/1078-0432.CCR-18-1116 

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Last Updated on June 21, 2018 by Marie Benz MD FAAD