All together now.

Speaking of response to immunotherapy, this study shows interesting differences in how metastatic malignancies respond and progress on immune checkpoint inhibition (ICI). After all, a metastatic cancer is an organism unto itself—harboring  myriad sub-populations of cells. Nonetheless, when there was any ICI response, it was usually across the board with 85% of NSCLC lesions and 93% of mismatch repair deficient lesions synchronously responding. When progression, occurred, though, it wasn’t so concerted. Half of progressions were mixed (dare we say oligo-progression), which was associated with favorable survival, perhaps signaling a good fit for consolidative focal therapy. TBL: Response to immunotherapy appears to be a system-wide event whereby anti-tumor immunity targets all sites of disease, while progression seems to be a more local event driven by evolution of individual lesions and micro-environments. | Osorio, J Clin Oncol 2019