Melanoma

The purpose of this article is to discuss the efficacy, indications for use, and safety of oral Hh pathway inhibitors for locally advanced BCC (LABCC) and for metastatic BCC (MBCC) through a review of the literature.

With a growing armamentarium for treating metastatic BRAF-mutated melanoma, choosing the right regimen can be difficult, says Jeffrey S. Weber, MD, PhD.

Sharpe, whose lab aided in the discover of the pathway, says blocking the pathway in order to treat cancers is important because it allows T cells to work better.

Yardena Samuels, PhD, on the ineffectiveness of targeting a single gene of proteins in patients with melanoma. Samuels says this strategy may work for the short term for treatment, but patients would tend to develop a resistance much quicker to treatment strategies using this method.

Despite limited information on treatment options for mucosal melanoma, Richard Joseph, MD, says immunotherapies could be a rewarding challenge for oncologists to undertake in the field.

Holmen says that utilizing targeted therapies could potentially be the answer, though clinically-tested combinations have historically not done as well as clinicians had hoped.

Weber says overactivity of these EGFR receptors may cause SCC tumors to become more aggressive. He adds that in a recent, small-scale study, effectively blocking the EGFR receptor in the tumor with anti-EGFR therapy proved to be successful.

Tumor infiltrating lymphocyte (TIL) technology represents an intriguing way of overcoming the immunosuppressive power of cancer, according to Jeffrey S. Weber, MD, PhD.

With the field of immunotherapy growing at a rapid rate, and its increasing incorporation in the armamentarium of treatments in melanoma, Jeffrey S. Weber, MD, PhD, discusses where the field is going and how oncologists can be using the therapies.

Nivolumab's new FDA expanded approval putsthe drug in the frontline for all patients with advanced melanoma, which Jedd D. Wolchok, MD, PhD, says will be beneficial for patients.

Single-dose fosaprepitant dimeglumine (Emend for injection) in combination with antiemetic agents has been approved by the FDA for the preventing

The frontline melanoma indications for nivolumab (Opdivo), as both a single agent and in combination with ipilimumab (Yervoy), have been expanded by the FDA to include patients with BRAF V600 mutations. This expansion was based on data from the phase III CheckMate-067 trial.

​Michael A. Davies, MD, PhD, discusses the importance of identifying which patients diagnosed with melanoma are at the highest risk for developing brain metastases.

Ashani T. Weeraratna, PhD, discusses the similarities in treatment between younger and older patients with melanoma. She says this lack of differentiation between treatment regimens could pose a problem in the future. One such issue is that older patients tend to react less well to treatments like vemurafenib.

A team in Australia have revealed the clinicopathological phenotypes and clinical activities of rarer BRAF mutations, namely BRAFK601E (K601E) and BRAFL597 (L597).

Sheri Holmen, PhD, discusses treating metastases in melanoma. Holmen says the treatment of metastases in melanoma is currently the cancer's biggest unmet clinical need, specifically brain metastases.

Omid Hamid, MD, discusses the upcoming Annual International Symposium on Melanoma and Other Cutaneous Malignancies.

With the continuously expanding landscape of treatment options for advanced and/or metastatic melanoma, it is becoming increasingly important to understand the patient-specific oncogenic drivers as a means of selecting treatments.

Talimogene laherparepvec (T-VEC; Imlygic) has been approved by the European Comission as a treatment for adult patients with unresectable stage IIIb, IIIc, and IVM1a melanoma that has not spread to the bone, brain, lung, or other viscera, based on the phase III OPTiM study.

Expanded approval for single-agent pembrolizumab (Keytruda) has arrived from the FDA to include frontline treatment for advanced melanoma regardless of BRAF status, based on a substantial improvement in progression-free and overall survival compared with ipilimumab (Yervoy) in the phase III KEYNOTE-006 trial

Danae Delivanis, MD, endocrinologist, Mayo Clinic, on the use of pembrolizumab and nivolumab in the treatment of metastatic melanoma.

The FDA has issued a complete response letter to Bristol-Myers Squibb regarding its supplemental biologics license application for the use of single-agent nivolumab in previously untreated patients with BRAF V600 mutation-positive advanced melanoma.

A regimen of pembrolizumab (Keytruda) and low-dose ipilimumab (Yervoy) was effective, and tolerable, for patients with advanced melanoma, according to results from the phase Ib KEYNOTE-029 clinical trial presented by lead investigator Georgina Long, BSc, PhD, MBBS.

Nivolumab (Opdivo) has been approved by the FDA as a single-agent to include the frontline treatment of patients with BRAF wild-type advanced melanoma.

A combination of dabrafenib and trametinib has been approved by the FDA for patients with unresectable or metastatic BRAF-mutated melanoma, based on an extension in overall survival (OS) from two phase III studies.