Melanoma & Skin Cancer

Jedd D. Wolchok, MD, discusses the implications of the expanded FDA approval of nivolumab, and the potential for the PD-1 inhibitor as both a single agent and as part of a combination regimen in advanced melanoma

The FDA has expanded the frontline melanoma indications for nivolumab as a single agent and in combination with ipilimumab to include patients with BRAF mutations.

Questions remain in terms of how to optimally sequence and/or combine both targeted agents and immunotherapies in melanoma.

The combination of atezolizumab (MPDL3280A) and vemurafenib (Zelboraf) yielded durable responses in patients with previously untreated BRAF V600–mutated metastatic melanoma in an ongoing phase Ib study.

Steven A. Rosenberg, MD, PhD, chief, Surgery Branch, senior investigator, head, Tumor Immunology Section, National Cancer Institute, explains advancements in adoptive cell therapy for the treatment of melanoma.

Jason J. Luke, MD, discusses potential new methods for determining prognostic markers in melanoma and the challenges of balancing toxicity with efficacy in designing combination regimens.

Victoria Atkinson, MD, discusses the impact of the phase III CheckMate-066 trial and nivolumab’s future as both a monotherapy and in combination with other therapies.

Jason J. Luke, MD, assistant professor of Medicine, The University of Chicago Medicine, discusses what the future holds for combination therapies for patients with melanoma.

Keith T. Flaherty, MD, discusses molecular testing issues and the use of combined BRAF/ MEK inhibition in patients with advanced/metastatic melanoma.

It is becoming increasingly clear that PD-1/ PD-L1 and CTLA-4 represent just the tip of the iceberg when it comes to manipulating the immune system to fight cancer, and the number of known checkpoints—and with it the list of potential drug targets—has expanded in recent years.

As clinical experience grows with new agents, combinations, and sequences of therapy, the use of molecular profiling in metastatic melanoma is likely to become an essential means of choosing among treatment options.

The European Commission has approved talimogene laherparepvec 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.

The FDA has expanded the approval for single-agent pembrolizumab to include the frontline treatment of patients with advanced melanoma regardless of BRAF status.

The MEK inhibitor binimetinib has demonstrated an improvement in progression-free survival compared with dacarbazine in patients with advanced NRAS-mutant melanoma.