Dr. Ribas on Immune-Related Adverse Events in Melanoma

Antoni Ribas, MD, PhD
Published: Tuesday, Feb 26, 2019



Antoni Ribas, MD, PhD, professor of medicine, University of California, Los Angeles, director, Tumor Immunology Program, Jonsson Comprehensive Cancer Center, discusses immune-related adverse events (irAEs) in melanoma.

With immune checkpoint inhibition, physicians have to be aware of the potential irAEs, which may include autoimmune reactions or inflammatory toxicities, says Ribas. Over time, physicians have become more comfortable with using these agents. As such, physicians have been able to better recognize and manage irAEs with earlier intervention strategies, some of which may include immunosuppressive agents, such as corticosteroids.

In terms of the therapies themselves, single-agent PD-1/PD-L1 therapy shows a lower frequency of irAEs compared with when it is used in combination with CTLA-4 inhibitors. In general, combination immunotherapy shows a higher rate of toxicity, says Ribas. Most recently, the FDA approved the PD-1 inhibitor pembrolizumab (Keytruda) as adjuvant therapy for patients with high-risk stage III melanoma with lymph node involvement following complete resection. Nivolumab (Opdivo) and ipilimumab (Yervoy) also hold indications in this setting.
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Antoni Ribas, MD, PhD, professor of medicine, University of California, Los Angeles, director, Tumor Immunology Program, Jonsson Comprehensive Cancer Center, discusses immune-related adverse events (irAEs) in melanoma.

With immune checkpoint inhibition, physicians have to be aware of the potential irAEs, which may include autoimmune reactions or inflammatory toxicities, says Ribas. Over time, physicians have become more comfortable with using these agents. As such, physicians have been able to better recognize and manage irAEs with earlier intervention strategies, some of which may include immunosuppressive agents, such as corticosteroids.

In terms of the therapies themselves, single-agent PD-1/PD-L1 therapy shows a lower frequency of irAEs compared with when it is used in combination with CTLA-4 inhibitors. In general, combination immunotherapy shows a higher rate of toxicity, says Ribas. Most recently, the FDA approved the PD-1 inhibitor pembrolizumab (Keytruda) as adjuvant therapy for patients with high-risk stage III melanoma with lymph node involvement following complete resection. Nivolumab (Opdivo) and ipilimumab (Yervoy) also hold indications in this setting.



View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant SettingsSep 28, 20191.5
Medical Crossfire®: What Does Data Tell Us About How to Optimize Checkpoint Inhibitor Strategies Across Lines of Care for Patients with Melanoma?Nov 30, 20191.5
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