SMR/ESMO Melanoma Spotlight

Adjuvant treatment with a combination of dabrafenib (Tafinlar) and trametinib (Mekinist) continues to show a long-term survival benefit in patients with melanoma, even across subgroup populations, according to a presentation at the 2017 World Congress of Melanoma (WCM).

According to updated results from the phase II ABC trial presented at the 2017 World Congress of Melanoma, Nivolumab (Opdivo) combined with ipilimumab (Yervoy) showed activity in asymptomatic patients with melanoma brain metastases who had not received prior local therapy to the brain.

While immunotherapty has led a transformation for melanoma care, combinations of anti–PD-1 and CTLA-4 agents are toxic, and biomarkers are not yet available to help personalize treatment. Therefore, Carolina Robert, MD, PhD, says, further research is needed to explore less toxic, more effective options.

In a small phase I study, engineered tumor-infiltrating lymphocytes demonstrated signs of antitumor activity in patients with metastatic melanoma following treatment with a prior checkpoint inhibitor. Results of the pilot study of TILs that were engineered to express transforming growth factor-β dominant negative receptor and nerve growth factor receptor were presented during the 2017 World Congress of Melanoma.

Triplet therapy with the combination of anti&ndash;PD-1/PD-L1 therapy, BRAF, and MEK inhibitors have already shown promise for patients with&nbsp;<em>BRAF</em>-positive advanced melanoma, and the potential for these combinations are increasing, according to Antoni Ribas, MD, PhD.&nbsp;

Michael A. Postow, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses BRAF and MEK inhibitor combinations studies in melanoma.

In patients with melanoma, the use of intralesional therapies in combination with checkpoint inhibitors has demonstrated to be an improvement to monotherapy and combinations with immunotherapy, according to a presentation by Robert Andtbacka, MD, at the 2017 World Congress of Melanoma.

Jeffrey S. Weber, MD, PhD, deputy director and co-director of the Melanoma Program at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Medical Center,

Frontline treatment with the combination of&nbsp;dabrafenib and trametinib induced an&nbsp;objective response rate of 64% (95% CI, 46%-79%) and a disease control rate of 75% in patients with&nbsp;<em>BRAF</em>-mutant metastatic non&ndash;small cell lung cancer.

Nearly half of patients with resectable stage IIIB/C BRAF V600-mutant melanoma achieved pathologic complete response with neoadjuvant treatment with dabrafenib and trametinib, according to results of a phase II study presented at the 2017 ESMO Congress in Madrid.

After a median follow-up of 2.8 years, the 3-year relapse-free survival rate in patients with <em>BRAF</em>-mutant stage III melanoma&nbsp;who were treated with adjuvant dabrafenib and trametinib was 58% compared with 39% for placebo,&nbsp;according to findings&nbsp;from the phase III COMBI-AD study.