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  • Sno 2020

    Hi
    I am still going through the SDNO 2020 abstracts and presentations. Already sat through 5 days of lectures! It is overwhelming. Here are some of what I think were the highlights. If anyone else went to the meeting, feel free to add what you saw!


    1. Optune had 43 presentations. All were positive – even the ones not funded by Novocure! Highlights include a long term update from the very first trial of 10 newly diagnosed and 10 recurrent glioblastoma patients. 20% of the patients (2 from each group) are still alive at around the 15 year mark. This is unheard of.

    New data from the registry shows a benefit (100% increase but it was only from 1.6 to 3.3 months) of Optune over the best of doctor’s choice for recurrent Glioblastoma. The original trial showed them to be equal but Optune having better quality of life and less side effects.

    2. RESPECT™ PHASE 1 CLINICAL TRIAL IN RECURRENT GLIOBLASTOMA from Plus Therapeutics showed impressive results even though a phase 1 trial is not really looking for survival advantage.

    3. Val-083: Phase 2 study results in recurrent unmethylated MGMT, Avastin Naïve Glioblastoma showed an impressive progression free survival in this difficult to treat group of patients.

    4. LTBK-01 - INO-5401 and INO-9012 delivered intramuscularly (IM) with electroporation (EP) in combination with cemiplimab (REGN2810) in newly diagnosed glioblastoma. Preliminary results show impressive progression free and overall survival. The unmethylated MGMT group did not use Temodar except during radiation and did better than historical data on Temodar.

    5. DNX2401 impressive results with recurrent gbm. 12.5 month median survival 54% clinical benefit rate.

    6. Small study shows No benefit of Temodar in IDH1/2 wildtype Anaplastic astrocytoma or glioblastoma , but big benefit in IDH1/2 mutant tumors. This is too small to be practice changing but it is the first time I ever heard that Temodar might be useless in most glioblastomas. More research needs to be done.

    7. Onc-201 Patients with H3 K27M-mutant DMG treated with ONC201 on active clinical trials (n=50, 27 thalamic, 23 brainstem) showed an overall survival (OS) of 28.1 (range: 5.9-105) months from diagnosis (enrollment by 4/29/19, data cut-off 12/28/19), compared to historical median OS of 12 months. Median OS for non-recurrent patients has not been reached (n=16, median follow-up: 16.8 from diagnosis). For non-recurrent thalamic patients (n=8), median PFS is 20.1 (range: 9.3-27.6) months from diagnosis (median time on drug: 14.5 months). Best response for thalamic patients by RANO: 1 CR, 5 PR, 7 SD, 8 PD, 6 not reported. This is way better than the currently used treatments and in my opion should be approved by the FDA immediately. Once it is approved we can try to figure out ways to make it work better.


    8. Most important lecture of the conference (in my opinion): Dr Johanna A. Joyce talking about microenviorment. It has a huge effect on outcome and has to be addressed. She says we need to combine drugs that each by itself doesn’t do much but in the right combinations can make a huge difference! (Sound familiar?)

    9. ERC1671 (Gliovac) for recurrent gbm: Showed median os of 10.8 months compared to randomized control of 6 month. No significant side effects. Again - this type of treatment needs to be approved so we can utilize them in combinations to find the cure!


    10. NCT03223103 Personalized vaccine + tumor treating fields. This is very early results in a small group of patients but looks good so far. 12 month PFS of 62.5% and 12 month os of 83%. Median survival not yet reached as 7 of the 9 patients were still alive at the data cutoff point.

    11. Poly ICLC + a DC vaccine in randomized trial shows a major improvement in OS and TTP. Hard to interpret the poster – they do not say if these are newly diagnosed or recurrent and they mix grade 3 and 4 but it was randomized. IF DCVAX gets approved soon, the first thing we should try is adding Poly ICLC to it!

    12. OKN-007 increases sensitivity to temozolomide. Very early results but looks promising. 20 month median overall survival for recurrent gbm for patients in the highest dosage group. There is a big dose response curve which indicates that the drug has an effect.

    13. BNCT Small trial but impressive results for recurrent gbm: 1 year survival was 79% and median OS was 18.7 months.








  • #2
    I also sat through the clinical trials course. There was so much discussion of why the current system isn't working and ideas how to fix it but it seems that with the current restraints, progress is not likely unless we luck into a miracle cure. I tried to inject my idea of the Promising Pathway Act but there was way too little time for questions and it never got answered.

    Comment


    • Harvey
      Harvey commented
      Editing a comment
      We’re there any news on POH trials? Regarding Optune +15 years survivors, did they mention something about how long did they use Optune? Regarding DNX 2401, did they mention something about the phase III trial, i.e. when do they plan to start it?

  • #3
    Hey Al, do you maybe know how would it be possible to get Poly ICLC?

    Comment


    • #4
      Do you know maybe if the Japanese Viral therapy G47delta was discussed? Last year they showed great results!

      Comment


      • #5
        It won't be easy but it might be possible to get it on expanded access. You can contact the company and ask.
        Originally posted by Harvey View Post
        Hey Al, do you maybe know how would it be possible to get Poly ICLC?

        Comment


        • #6
          Originally posted by Harvey View Post
          Do you know maybe if the Japanese Viral therapy G47delta was discussed? Last year they showed great results!
          I just searched and there is nothing on G47 delta. Sorry..

          Comment


          • #7
            So I learned that Prof. Todo will present newest status of the viral
            > therapy at the conference on 16th of December.
            >
            > Live stream and live Q&A session is planned!
            >
            > Maybe you would be interested in taking part.
            >
            > http://ispno2020.umin.jp/program/index.html

            > <http://ispno2020.umin.jp/program/index.html>
            >
            > BR,
            > Harvey

            Comment


            • #8
              Looks good! But it is 30,000 yen to register. Can you tell us what they say? Are you registering?

              Comment


              • Harvey
                Harvey commented
                Editing a comment
                I didn’t take part..but David M. Ashley held a joint presentation with prof. Todo on brain immunotherapy..do you know Mr. Ashley? Can you ask him what does he think about practical use of g47delta? Thanks, harvey

            • #9
              I know Dr Ashkley - will ask him!

              Comment


              • Harvey
                Harvey commented
                Editing a comment
                Did you maybe got an answer? Thanks

            • #10
              Not yet. Will let you know if I do.

              Comment


              • #11
                I got a response from Dr Ashley - he was away on vacation.. he said the G47 is very interesting but it is too early to really tell.

                Comment


                • #13
                  Very exciting! Does anyone know the timeframe for a decision?

                  Comment


                  • #14
                    Hi Al,
                    I'm quite interested in the long-term survivor study with Optune/TTF, with an update reported at the SNO meeting. https://academic.oup.com/neuro-oncol...dFrom=fulltext
                    Was there any poster or presentation of further details on these patients at the 2020 SNO meeting?
                    Thanks.

                    Comment


                    • #15
                      That was only presented as an abstract at the meeting. It is very interesting. I met one of those 4 long term survivors at a conference about 10 years ago and again a few years ago.He is leading a normal life, with a family, working and in perfect shape. Obviously not everyone responds like that but I think one of the secrets to the success of that phase 1 trial was they continued to use Optune even when it looked like progression on MRI. At that time the thinking was there is nothing else that helps recurrent GBM so why not try to continue it.. and it worked in a few people. I think we have been stopping it too soon. I asked them about the effect where the tumor seems to grow on most patients and they sent me a nice response: https://virtualtrials.org/optune/Musella/Musella.pdf basically it is now expected to show a little growth on the next scan before the scans start to look better. It takes time to work.

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