Ryan Sullivan, MD

Ryan Sullivan, MD, associate professor, Medicine, Harvard Medical School and associate professor, Hematology/Oncology, Massachusetts General Hospital, explains how tumor infiltrating lymphocytes (TIL) could impact the melanoma treatment landscape if approved by the FDA.

 Having a therapy that's totally a different type of therapy than what we have available offers a lot of potential. One next step may be combining it with the things we already have. It may be combined with anti PD-1, anti-PD-1 plus anti CTLA4, or anti-PD-1 and LAG3. It may also be explored in earlier lines of therapy or in the refractory space.

 There's some data with other compounds that suggested that combining these types of drugs with a novel immunotherapy could be useful, even if patients had previously been treated with an anti-PD-1-based regimen. I think that's the second thing, that there may be combinations of therapies that currently are being studied, and it potentially could be a next step beyond just having TIL. The other thing is that there are a lot of ways of modifying and manipulating cells. If you’re getting a TIL harvest from a patient, it's entirely possible that there are ways to make those TIL better. You could select for tumor antigen specific T cells. You can select or treat those cells in a way to make them a better TIL. There's data that's been generated from a lot of labs in this space trying to come up with a better way of not necessarily giving TIL, but a better product that they can generate just by doing certain modifications after the TIL is harvested and before patients receive the TIL.

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Ryan Sullivan, MD, explains how tumor infiltrating lymphocytes could impact the melanoma treatment landscape if approved by the FDA.

Potential Impact of Tumor Infiltrating Lymphocytes on Melanoma Treatment

Ryan Sullivan, MD, associate director, Melanoma Program, Massachusetts General Hospital Cancer Center, discusses the 5-year data pooled from the phase III COMBI-d and COMBI-v trials, which each studied dabrafenib (Tafinlar) plus trametinib (Mekinist) in patients with

mutant unresectable or metastatic melanoma.

Overall, patients from both studies had similar responses and stable disease. The OS rate was 37% in the COMBI-d patients and 34% in the COMBI-v patients. Sullivan says this response is a result of a plateauing effect, which appears to be similar to what is seen with immunotherapy treatment in these patients.

Additionally, for the subset of patients who had lower or normal lactate dehydrogenase (LDH) and less than 3 metastatic sites, upfront

inhibitor combination therapy led to a durable PFS rate of 30% to 35%.

The phase III COMBI-d and COMBI-v trials are complete and show long-term benefit for patients with

Ryan Sullivan, MD, discusses the 5-year data pooled from the phase III COMBI-d and COMBI-v trials, which each studied dabrafenib (Tafinlar) plus trametinib (Mekinist) in patients with&nbsp;<em>BRAF V600</em>&ndash;mutant unresectable or metastatic melanoma.

Ryan Sullivan, MD | Authors

Articles

Potential Impact of Tumor Infiltrating Lymphocytes on Melanoma Treatment

Promising Data on the Combination of Dabrafenib and Trametinib in BRAF V600-Mutant Melanoma