EPIDEMIOLOGY

Cancer Immunotherapy:  Epidemiology1-15

  • Lung cancer is the most common cancer type worldwide. NSCLC accounts for 85-90% of lung cancer cases.
  • Smoking plays a causative role in 70-90% of all lung cancer cases.
  • Urothelial bladder cancers are the 9th most common form of cancer in the world. Urothelial carcinoma accounts for 90-95% of cases and represents the most common type of bladder cancer.
  • The 5-year overall survival rate of metastatic bladder cancer is less than 15%. Approximately 30% of new bladder cancer patients present with muscle invasive tumors that can rapidly progress and metastasize, all of which are associated with a poor prognosis.
  • The number of patients eligible for cisplatin-based treatment for urothelial bladder cancers is decreasing to less than 50%, exposing a need to expand treatment options for this patient cohort.
  • As the 12th most common cancer in the world (along with pancreatic cancer), the incidence of renal cell carcinoma varies, with the highest rates in the Czech Republic and North America.
  • Immune checkpoint inhibitors are considered to be the most important breakthrough in cancer treatment in the past decade.
  • Since 2010, new immunotherapies (not linked to cytokines) such as sipuleucel, ipilimumab, pembrolizumab, durvalumab, nivolumab and atezolizumab have gained various indications for prostate cancer, melanoma, NSCLC and bladder cancer.
  • The most advanced immunotherapies available for cancer treatment include cytotoxic T-lymphocyte-antigen 4 inhibitors (CTLA-4), programmed cell death protein1 (PD-1) inhibitors and programmed cell death ligand 1 (PD-L1) inhibitors.
  • A recent study of European oncologists revealed less than 50% of the oncologists surveyed reported understanding immune-related response criteria and their relevance to cancer immunotherapy.
  • The most common AEs in recent clinical trials evaluating PD-1 pathway inhibition include fatigue, nausea, rash, diarrhea, decreased appetite and infusion-related reactions.

 

References

  1. Abdel-Rahman O, ElHalawani H, Fouad M. Risk of cutaneous toxicities in patients with solid tumors treated with immune checkpoint inhibitors: a meta-analysis. Future Oncol. 2015;11(17):2471-2484.
  2. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86
  3. Herbst RS, Heymach JV, Lippman SM. Lung Cancer. N Engl J Med. 2008;359:1367-1380.
  4. Rouprêt M, Babjuk M, Böhle A, et al. European Association of Urology 2015. Guidelines on
  5. Urothelial Carcinomas of the Upper Urinary Tract. http://uroweb.org/wp-content/uploads/06-UTUC_druk_LR.pdf. Accessed on October 20, 2016.
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  7. Dash A, Galsky MD, Vickers AJ, et al. Impact of renal impairment on eligibility for adjuvant cisplatin based chemotherapy in patients with urothelial carcinoma of the bladder. Cancer. 2006;107:506-513.
  8. De Santis M, Bellmunt J, Mead G, et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer “unfit” for cisplatin-based chemotherapy: phase II–results of EORTC study 30986. J Clin Oncol. 2009;27:5634-5639
  9. Pennell NA. Understanding the Rationale for Immunotherapy in Non-Small Cell Lung Cancer. Semin Oncol. 2015 Oct;42(Suppl 2):S3-S10.
  10. Garon EB. Current Perspectives in Immunotherapy for Non-Small Cell Lung Cancer. Semin Oncol. 2015;42(Suppl 2):S11-S18
  11. Borrello IM, Schaffer MM, Roehrl E, et al. Identification of differences in immunotherapy knowledge and practice patterns among oncologists from six European countries. Mol Clin Oncol 2014;2:269–74
  12. Topalian SL, Hodi FS, Brahmer JR, et al. Safety, Activity, and Immune Correlates of Anti-PD-1 Antibody in Cancer. N Engl J Med. 2012;366(26):2443-54.
  13. Bellmunt J, Mullane SA, Werner L, et al. Association of PD-L1 expression on tumor-infiltrating mononuclear cells and overall survival in patients with urothelial carcinoma. Ann Oncol. 2015;26:812-817.
  14. Hodi FS, O’Day SJ, McDermott DF, et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med. 2010;363(8):711-723.
  15. Robert C, Thomas L, Bondarenko I, et al. Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. N Engl J Med. 2011;364:2517-2526.

Epidemiology

Pathophysiology

Treatments

Additional Reading