Wednesday, August 17, 2016 8:28:05 PM
What you are referring to was a post hoc analysis, a retrospective look if you will, that was not part of the original phase II monotherapy design. Patients weren't randomly selected to go on and test anti-pd-1 drug as part of the monotherapy il-12 trial.
The fact that the trial didn't use a TIL biomarker shouldn't negate the stellar post hoc clinical responses. Remember, the il-12 monotherapy achieved response rates that were better than anti-pd-1 or ctla-4 therapies. These patients who responded were not later evaluated in the post hoc analysis. Those who did not respond likely had a proportional increase in pd-1/ctla-4 positive TIL, but obviously those patients won't respond until the anti-pd-1 drug is introduced. And when patients did subsequently go on to an anti-pd-1 therapy, they responded at 75% with 50% complete remissions. Those percentages are completely unheard of in stage III and IV melanoma. Electroporated il-12 sure seems to be increasing the relative proportion of pd-1 positive TIL in tumor microenvironments. This is the necessary 'substrate' we keep hearing about. Without il-12, these advanced stage melanoma patients should only be achieving 20-30% response rates, with less than 10% complete remission.
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