Improving Distant Control in Lung Cancer With JNJ-1900 and Keytruda

Improving distant control of lung cancer is the most exciting potential benefit of combining JNJ-1900 with Keytruda (pembrolizumab), explained by Dr. Jared Weiss.

JNJ-1900 is a novel radioenhancer designed to be injected directly into tumors before hypofractionated radiation, helping maximize tumor destruction at that site while also potentially stimulating the immune system to fight cancer elsewhere in the body — an effect known as the abscopal effect.

Although this phenomenon has historically been rare, Weiss noted that real abscopal responses have been seen in metastatic disease with this approach, providing hope that the combination could improve distant control for patients with localized lung cancer.

Weiss is the section chief of Thoracic and Head/Neck Oncology at the UNC Lineberger Comprehensive Cancer Center, located in Chapel Hill, North Carolina. Weiss also serves as a professor of medicine in the Department of Medicine, Division of Oncology, at the UNC School of Medicine.

Transcript:

Are there any early indications of efficacy or biological activity in the current study cohort that might suggest potential for improving outcomes in patients that are being treated with this agent?

So the best indication that we might have efficacy in the localized setting is the efficacy that we've seen in the metastatic setting. My greatest fear when I treat a patient with a goal of cure with localized lung cancer is that they are going to recur with distant spread. Metastatic or distant spread is what causes most of the suffering and most of the death. And so when we look at the emergence of novel therapeutics for lung cancer, they're mostly oriented around improving that distant control.

Historically, that's been medicines. Medicines are nice because they get just about everywhere in the body. They go through the bloodstream. And this is a very novel, have-your-cake-and-eat-it-too type strategy in that you're doing something local. But what's really exciting about it for me — yes, it helps you fry the local thing, and that's nice — but it also does help with distant control. When you treat one spot with 1900 and then introduce [Keytruda], you have better control at distant spots. That effect, when you treat one area and you have efficacy elsewhere, is called the abscopal effect. Historically, it's something that had this huge ratio of how much radiation oncologists talked about it to how much it actually happened in the real world — probably 20 to one, at least. But there are real abscopal effects in metastatic disease with 1900, and that gives me a lot of hope that treatment in the localized context will improve distant control.

Transcript has been edited for clarity and conciseness.

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