Melanoma

Richard Carvajal, MD, Director of Experimental Therapeutics and Director of the Melanoma Service at Columbia University Medical Center, discusses options for treating melanoma after the use of targeted therapies and immunotherapy. 

According to results from a randomized, double-blind, phase III study, patients with stage III or IV melanoma assigned to 10 mg/kg ipilimumab lived longer than patients assigned to a lower dose of the anti-CTLA-4 anticlonal antibody, but at the cost of greater toxicity.

Michael B. Atkins, MD, deputy director, Georgetown-Lombardi Comprehensive Cancer Center, professor of Oncology and Medicine, Georgetown University School of Medicine, discusses the ideal therapy for melanoma in the adjuvant setting.

Ann W. Silk, MD, discusses preliminary results of the CAPRA trial, a phase 1B study of intratumoral coxsackievirus A21 (CVA21; CAVATAK) and systemic pembrolizumab in patients with advanced melanoma.

Combining the IDO inhibitor indoximod with pembrolizumab led to an overall response rate of 52% in patients with advanced melanoma.

Adding a formulation of the Coxsackievirus A21 to ipilimumab yielded an overall response rate of 50% and was well-tolerated in immunotherapy-naïve and pretreated patients with advanced melanoma.

BGB-283, a novel agent that targets <em>RAS/RAF</em>-mutated tumors, demonstrated activity across a variety of tumor types, according to the results of a preliminary clinical evaluation presented at the 2017 AACR Annual Meeting.

Yousef Zakharia, MD, assistant professor, University of Iowa, Holden Comprehensive Cancer Center, discusses an interim analysis of the phase II clinical trial investigating the IDO pathway inhibitor indoximod in combination with pembrolizumab (Keytruda) for patients with advanced melanoma.&nbsp;

The PD-1 and CTLA-4 inhibitor combination of nivolumab (Opdivo) and ipilimumab (Yervoy) induced a 12% reduction in the risk of death versus nivolumab monotherapy in patients with treatment-na&iuml;ve advanced melanoma.

The American Association for Cancer Research (AACR) will recognize several individuals for their contributions to cancer research during its annual meeting, to be held April 1 to 5 in Washington, DC.

The first-in-class IDO1 inhibitor epacadostat (INCB024360), currently being investigated in&nbsp;combination with the PD-1 inhibitor pembrolizumab (Keytruda), could be an exciting new FDA approval for patients with stage III/IV unresectable or metastatic melanoma.

As immunotherapies become a greater part of the treatment paradigm of various cancers, researchers are spending more time developing ways to determine which patients will respond better to immunotherapy. Mutational load is one such biomarker that appears to have an impact on response to immunotherapy, particularly for checkpoint inhibitors.

A new drug application for the MEK inhibitor binimetinib as a treatment for patients with <em>NRAS</em>-mutant advanced melanoma has been withdrawn by Array BioPharma.

Jeffrey S. Weber, MD, PhD, deputy director of the Laura and Isaac Perlmutter Cancer Center, co-director of the Melanoma Program, and head of Experimental Therapeutics at NYU Langone Medical Center, discusses combination strategies for <em>BRAF</em>-mutant melanoma.

Michael A. Postow, MD, discusses&nbsp;argeting the activating receptors OX40, GITR, and CD137 to further stimulate the T cells to fight the tumor cells.

As the oncology community adapts to using immunotherapy agents more frequently in cancer treatments, the fear over immune-related adverse events (irAEs) prevents many clinicians from fully trusting immunotherapies.

Helmut Schaider, MD, discusses&nbsp;why drug resistance in melanoma may be due to epigenetic changes and not mutation-induced changes, as well as the role of immunotherapy/targeted therapy combinations in combating resistance.

Dabrafenib combined with trametinib continued to demonstrate durable efficacy for patients with <em>BRAF</em> V600E/K-mutant melanoma.

Michael A. Postow, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses targets beyond PD-1 in melanoma.

The combination of nilotinib and trametinib proved to be synergistic in <em>BRAF/NRAS</em> wild-type melanoma,&nbsp;according to a recent study presented at the 2016 Society for Melanoma Research Congress.

The combination of dabrafenib and trametinib before and after surgery demonstrated a dramatic improvement in relapse-free survival compared with the standard of care for patients with stage IIIb/c or oligometastatic <em>BRAF</em>-mutant melanoma.

Stefani Spranger, PhD, discusses how the presence or absence of CD8-positive T cells can affect treatment approaches for patients with melanoma.

BRAF inhibitor encorafenib combined with the MEK inhibitor binimetinib reduced the risk of progression or death by 46% compared with vemurafenib for patients with <em>BRAF</em>-mutant unresectable melanoma.

Results from a safety, tolerability, and dose escalation phase Ib/II study involving intratumoral SD-101 and pembrolizumab have demonstrated that the combination was well-tolerated with no dose-limiting toxicities in early-stage melanoma.

Neoadjuvant therapy with the combination of nivolumab and ipilimumab is plausible and effective, but can induce a high level of adverse events calling for further research into better tolerated dosing schemes.