Dr Atkins shares his approach to first-line treatment and reviews data regarding treatment sequencing from the DREAMseq Trial.
Case: A 62-Year-Old Female with Stage IV Melanoma
This is a video synopsis/summary of a Case-Based Peer Perspectives episodefeaturing Michael B. Atkins, MD.
The DREAMseq trial helped determine optimal first-line therapy and sequences for BRAF-mutant metastatic melanoma. Patients were randomly assigned to nivolumab plus ipilimumab or dabrafenib plus trametinib, with crossover at progression. The primary end point was 2-year overall survival (OS).
The trial was stopped early when an interim analysis at 59% of enrollment showed a clinically meaningful difference favoring first-line immunotherapy: a 20% 2-year OS benefit over targeted therapy first. Progression-free survival, duration of response, and median OS were also improved with immunotherapy in the first line. Patients on targeted therapy without progression could cross over to immunotherapy.
Although targeted therapy responses may occur faster, combination immunotherapy also works quickly. Results of neoadjuvant trials show almost complete regional nodal response after just 6 weeks, suggesting similar response kinetics in metastases that are harder to assess radiographically.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
Dosing and Regimen Changes Promote Tolerability in Advanced Melanoma
March 14th 2024During a Targeted Oncology™ Case-Based Roundtable™ event, Michael B. Atkins, MD, discussed dosing considerations and toxicity when choosing combination treatment for patients with melanoma. This is the second of 2 articles based on this event.
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