We were pleased to have Dr. Katie Kurnit (@KatieKurnit) a gynecologic oncologist from the University of Chicago (@UCCancerCenter) join us for our chat on Using Immunotherapies to Treat Gyn Cancers.
Below is a sampling of the responses to our topic questions. You may find the transcript here and analytics here.
T1: What is immunotherapy? How is it different from other gyn cancer treatments (surgery, chemo, radiation)? How many types of immunotherapy are there?
- via@AmericanCancer Immunotherapy is treatment that uses a person's own immune system to fight cancer. Immunotherapy can boost or change how the immune system works so it can find and attack cancer cells.
- T1: Immunotherapy is a cancer treatment that works with the person’s immune system to fight cancer. This makes it different from chemotherapy which focuses more on killing cancer cells directly. (1/2)
- T1: Both immunotherapy and chemo can travel throughout the body, rather than focusing on a specific area of the body like radiation or surgery. And there are lots of different immunotherapy treatments emerging now! (2/2) #gyncsm
- This graphic from the @AACR Cancer Progress Report shows the different types of immunotherapies
T2: Which gyn cancers have immunotherapy treatments approved by the FDA?
Are there immunotherapies in trials now that show promise?
- T2: Currently, both #cervicalcancer and endometrial cancer have tumor type-specific @FDA approvals. Each of these indications requires some molecular testing on the tumor to help determine which regimen would be best. (1/2)
- T2: There are also broader approvals that are based on a molecular test result, such as mismatch repair deficiency or high tumor mutational burden, that have immunotherapy approvals for any type of cancer . (2/2)
- Excellent review of immunotherapies in this @ASCO publication ascopubs.org/doi/10.1200/ED Immunotherapy in Gynecologic Cancers: What We Know Now and Where We Are Headed
- Here's another excellent one specific to #ovariancancer #gyncsm ascopubs.org/doi/full/10.12 Cervical Cancer immunotherapies include vaccines like Gardasil-9® for HPV , ADC like Tisotumab vedotin and ICI Pembrolizumab cancerresearch.org/cancer-types/c
- Immune response very critical given #cervicalcancer and other #hpvcancers are viral mediated! Would just clarify the #hpv vaccine is available for primary prevention but not tx but others are for therapy of recurrent disease currently
T3: How is it determined if immunotherapy is an appropriate treatment option for an individual?
- Your general health is considered. What kind of cancer; size of tumor; stage. Have you had prior treatment?
- T3: The individual and doctor would discuss the pros/cons of both the immunotherapy and the other treatment choices. Certain medical conditions, like some autoimmune diseases, may make it less safe to use immunotherapy.
- T3: There is a need to improve access to molecular tests, especially in developing countries. This limits the decision to use immunotherapy.
- T3: Even if no immunotherapy is approved, remember that many other immunotherapies are being tested in clinical trials
- T3: currently FDA approval in #gyncsm is in endometrial and cervical depends on specific molecular testing; testing can also help clarify immunotherapy alone vs with other drugs ex. Pembro/lenvima vs Pembro only in #endometrialcancer recurrence
T4: What is the immunotherapy treatment experience like?
What are the common side effects with immunotherapy and how do they differ from other gyn cancer treatments?
- T4: In general, I've found that many people feel well while receiving treatment with an ICI, and may end up staying on this treatment for several yrs if it works well. Side effects are different than chemo
- T4 One different one that I heard of was blurry vision on Mirvetuximab soravtansine. Certain eye drops were prescribed for use during the treatment. But it was not a long term effect.
- yes! being aware of side effects seen in #clinicaltrials of these newer drugs allows us to be prepared and have a plan in place to treat symptoms when they arise
- T4: Like any cancer treatment, side effects vary widely between individuals. It important to stay in communication with your healthcare team about side effects and there are many options to try to mitigate various side effects.
- T4: Side effects are different from traditional chemo, and are often due to inflammation by the immune system; so-called “-itis” es. Ex colitis (inflammation of the colon), thyroiditis (of the thyroid), hepatitis (liver), etc.
T5/6: What advice would you give to others considering an immunotherapy treatment or trial?
What are some resources for learning more about immunotherapy in treating gyn cancers?
- One good resource is Society for Immunotherapy of Cancer (@sitcancer) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer jitc.bmj.com/content/11/6/e
- clinicaltrials.gov/study-basics/l
- T5/6: I am really excited about the future of immunotherapy in #gynonc ! The way we learn more is through #clinicalresearch and #clinicaltrials. Lots of exciting new types of immunotherapies are coming down the pipeline
- T5/6 This video has good information about immunotherapies youtube.com/watch?v=9zd-lT
The Society for Gynecologic Oncology @SGO_org is hosting their meeting March 16-18. So stay tuned over the next few days to #SGOMtg for updates on immunotherapy and all things gyn cancer related. We'll do a #gyncsm research update chat this summer.
Dee and Christina
#gyncsm Co-founders
Additional Resources
Cancer Research Institute resources on immunotherapy
Cervical cancer https://www.cancerresearch.org/cancer-types/cervical-cancer
Ovarian cancer https://www.cancerresearch.org/cancer-types/ovarian-cancer
Uterine Endometrial https://www.cancerresearch.org/cancer-types/uterine-endometrial-cancer
CancerDotNet Side Effects
American Cancer Society - Side Effects
Monoclonal Antibodies
Immune Checkpoint Inhibitors
NCI general immunotherapy page
