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Combination of Pembro and Liposomal Gemcitabine Shows Safety in Solid Tumor Patients

— Feasibility and dose limiting toxicity findings prompt further investigation into tumor responses

Last Updated July 24, 2024
MedpageToday

Liposomal gemcitabine in combination with pembrolizumab shows promise in the treatment of advanced solid tumors, according to presented at the recent American Society of Clinical Oncology (ASCO) meeting.

In this exclusive app video, Charles Farber, MD, PhD, Medical Director of the Oncology Research Network Development at the Atlantic Health System in Morristown, New Jersey, discusses the feasibility and tolerability of this combination therapy.

Following is a transcript of his remarks:

This was a clinical trial initially using a drug that is well established in oncology, gemcitabine. It was approved many years ago and it has a fair amount of activity, truly is an impactful drug widely used for a number of malignancies, often pancreatic biliary as well as genitourinary malignancies. And Fujifilm came out with a different chemical form using technology that had been established for other chemotherapy agents, liposomal. Putting the chemotherapy agent in a liposome, which changes its physical characteristics, it makes it lipophilic so it can get into different tumors and different parts of the body, different compartments that the regular molecule cannot penetrate.

So it's very appealing because one of the things, if you can get more chemotherapy into a tumor, it may make a resistant tumor sensitive. It may be able to more effectively eliminate the tumor after an adequate trial. A handful of patients, they moved on to using it in combination with pembrolizumab, Keytruda, a checkpoint inhibitor.

So of course the checkpoint inhibitors are a very, very exciting class of drugs. Many patients, absolutely miraculous, unfortunately not in all patients, and there may be a synergy between chemotherapy and using a checkpoint inhibitor. We use it in many different settings, including lung cancer, bladder cancer, and others.

So combining a checkpoint inhibitor with a chemotherapy drug, particularly potentially a novel chemotherapy drug like liposomal gemcitabine, represents a very exciting strategy. And it appears in the study, phase II study, to be feasible. It appears that the patients tolerated the treatment. Again, it wasn't so much looking at tumor responses as it was seeking the practical schedule and dose-limiting toxicity, and the decision was made to go on to treat more patients with the combination.

Now, the next phase of the investigation would be to determine if we see significant responses, if patients actually do have objective shrinkage of their tumors. And of course, the highest level of information would be to determine if there's improved survival, better outcomes.

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    Greg Laub is the Senior Director of Video and currently leads the video and podcast production teams.