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Friday, November 16, 2012 2:11:21 PM
There are some sections relevant to bavituximab.
Immunology beats cancer: a blueprint for successful translation
Drew M Pardoll
Abstract
Immunology offers an unprecedented opportunity for the science-driven development of therapeutics.
The successes of antibodies to the immunomodulatory receptor CTLA-4 and blockade of the immunoinhibitory
receptor PD-1 in cancer immunotherapy, from gene discovery to patient benefit, have created a paradigm for
driving such endeavors.
[snip]
Many interesting clinical insights came from
the 12 years of clinical experience with ipilimumab.
First, the kinetics of clinical responses
to anti-CTLA-4 (that is, tumor shrinkage)
tend to be much slower than those of chemotherapy
or tyrosine-kinase inhibitors, and in
some patients, tumor regression is preceded
by apparent progression, as assessed by computerized
tomography or magnetic resonance
imaging. Such findings suggest a mechanism
of action compatible with the original report
by Hodi and Dranoff showing that ultimate
tumor regression is preceded by activation
of the immune system and infiltration of the
tumor by activated lymphocytes. Additionally,
although formal regressions are induced in a
relatively small proportion of patients and
complete responses, as assessed by computerized
tomography or magnetic resonance imaging,
are rare (<5%), roughly 20% of patients
treated with only four doses of ipilimumab
remained alive over 4 years after therapy (in
contrast to ~5% of control patients). Wolchok,
Hoos and colleagues recognized that these
response qualities were different from those of
conventional cancer therapies and developed
the concept of ‘immune-response criteria’ to
help clinicians evaluate the efficacy of this new
class of immunotherapy in their patients. The
durable responses in advanced melanoma suggest
that the dream of cancer immunotherapy—
an appropriately activated endogenous
antitumor immune response that can have
memory and keep cancers at bay long after the
cessation of therapy—may not be so fanciful.
With the approval for the use of ipilimumab
to treat melanoma in hand, analysis of the use
of ipilimumab to treat many other cancers is
being aggressively pursued.
[snip]
http://www.nature.com/ni/journal/v13/n12/abs/ni.2392.html
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