Melanoma

David Polsky, MD, PhD, discusses methods to identify circulating tumor DNA in patients with melanoma.

From 2001 to 2017, the cancer death rates continued to decline in the United States, and these decreases were observed in all major racial and ethnic groups, as well as in males, females, adolescents, young adults, and children. However, the rates of cancer incidence for all cancers slightly increased in females from 2012 to 2016, according to the Annual Report to the Nation on the Status of Cancer, which was published in Cancer.^ 

Adjuvant treatment with talimogene laherparepvec in patients with resectable advanced melanoma demonstrated better recurrence-free survival and overall survival compared with surgery alone, according to results of a study presented at a poster session at the 16th International Congress of the Society for Melanoma Research.

Craig L. Slingluff, MD, explains the rationale behind part B1 of the MAVIS study , which is investigating the use of the Seviprotimut-L vaccine in melanoma.

Performing a liquid biopsy of circulating tumor cells may help identify patients who are at risk for node-positive melanoma relapse and identify patients who wish to avoid the toxicities associated with systemic adjuvant therapy, according to the results of a prospective study from The University of Texas MD Anderson Cancer Center, which was recently published in Clinical Cancer Research.

Ryan J. Sullivan, MD, compares the toxicity profiles of BRAF-targeted therapy and immunotherapy used for the treatment of patients with melanoma.

In an interview with Targeted Oncology, Pier Francesco Ferrucci, MD, discussed the findings from the updated analysis, which he shared in a presentation at the 16th International Congress of the Society for Melanoma Research, highlightening the important takeaways from this follow-up analysis.

Georgina V. Long, BSc, PhD, MBBS, FRACP, discusses the current treatment options that are approved around the world for patients with advanced melanoma. These treatments include both immunotherapies, such as immune checkpoint inhibitors, and targeted therapies.

The combination of atezolizumab, cobimetinib, and vemurafenib reduced the risk of disease progression or death compared with placebo in patients with BRAF V600 mutation-positive advanced melanoma, meeting the primary endpoint of progression-free survival in the phase III IMspire150 study, according to a press release from Roche.

Treatment with immunotherapy has become ingrained in the standard of care for treating patients with melanoma, but investigators continue to research new combinations and treatment strategies that can improve patients outcomes. One approach that has generated a great deal of interest and is a significant focus of ongoing trials involves adjuvant and neoadjuvant therapy, according to Jeffrey S. Weber, MD, PhD.

Adil Daud, MD, compares the roles of immunotherapy versus dabrafenib plus trametinib targeted therapy combinations in patients with advanced melanoma. The latter combination is appropriate and even preventative in select patients, but the decision between checkpoint immune therapy and immunotherapy comes down to what is best for each patient.

The combination of nivolumab with ipilimumab showed no statistically significant benefit in patients with stage IIIB/C/D or stage IV melanoma compared with nivolumab alone in the phase III CheckMate 915 study, missing the co-primary endpoint of recurrence-free survival  in patients with <1% PD-L1 expression in their tumor cells, according to a press release from Bristol-Myers Squibb.

Thomas Marron, MD, discusses the rationale for investigating immunotherapy discontinuation in patients with melanoma.

In an interview with Targeted Oncology, Jeffrey S.Weber, MD, PhD, discussed the 3-year efficacy and biomarker results from the phase III CheckMate 238 trial, which he presented at the 2019 European Society of Medical Oncology Congress.

The use of CMP-001, an intratumoral toll-like receptor 9 agonist, is capable of triggering durable responses when used in combination with pembrolizumab for patients with PD-1 resistant metastatic melanoma according to results from a phase Ib study presented at the Society for Immunotherapy of Cancer’s 34th Annual Meeting.

Immunotherapies and targeted therapies have greatly impacted the treatment of advanced melanoma and are beginning to make their way into earlier settings, with FDA approvals for adjuvant therapies and studies ongoing in the neoadjuvant space, according to a presentation by Jeffrey S. Weber, MD, PhD, at the <em>37th Annual</em> CFS.

During a <em>Targeted Oncology </em>live case-based peer perspectives live discussion, Anna C. Pavlick, DO, MS, explained to a group of physicians best practices for the diagnosis and management of patients with metastatic melanoma. Pavlick, discussed treatment options between immunotherapy and targeted therapy based on the case scenario of a patient with <em>BRAF </em>wild-type metastatic melanoma.

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.

&ldquo;New therapies have increased the median survival for advanced-stage melanoma from approximately 9 months before 2011 to at least 2 years, based on [data from] clinical trials,&rdquo; Elizabeth Ward, PhD, and colleagues wrote about their report on cancer burden in younger patients.

In a recent review of the 5-year outcomes from the COMBI-d and COMBI-v trials published in the&nbsp;New England Journal of Medicine, investigators saw long-term benefit with the use of dabrafenib plus trametinib as first-line treatment in about one-third of patients with unresectable or metastatic melanoma and&nbsp;BRAF V600E or V600K mutations.

Keith T. Flaherty, MD, discusses the combination regimens and the potential role for a 3-drug regimen as treatment for patients with melanoma. He says investigators have been searching for new combination strategies beyond the combination of BRAF and MEK inhibitors.

In an interview with&nbsp;Targeted Oncology, Shailender Bhatia, MD, highlighted the key takeaways from the 5 abstracts he found most significant at the 2019 ASCO meeting for the treatment of patients with melanoma.

In an interview with <em>Targeted Oncology</em>, Michael Atkins, MD, discussed the latest follow-up data from the combination of nivolumab and ipilimumab across 2 trials and next steps in the research with this combination for patients with advanced melanoma.

The combination of bempegaldesleukin and nivolumab was granted a breakthrough therapy designation by the FDA&nbsp;for the treatment of patients with previously untreated unresectable or metastatic melanoma.

David Polsky, MD, PhD, discusses the findings from a liquid biopsy analysis of the COMBI-d trial, which is a phase III trial investigating the combination of dabrafenib and trametinib or dabrafenib alone in patients with BRAF V600E/K&ndash;mutant melanoma. Investigators found an association between the presence of baseline circulating tumor DNA (ctDNA) and a poor prognosis with the treatment of BRAF inhibitors.