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Adjuvant Therapy in Melanoma: What's Coming Next?

Insights From: Merrick I. Ross, MD, University of Texas MD Anderson Cancer Center
Published: Tuesday, Oct 02, 2018



Transcript: 

Merrick I. Ross, MD: It’s really an exciting time for patients who have melanoma, particularly the high-risk patient population. It’s also very exciting for the treating physicians because we have great options for patients. There has really been a revolution in both the stage 4 and adjuvant settings. The next group of trials will look at high-risk patients, but in a different setting. The high-risk stage 2 patients who don’t have lymph node involvement, particularly if they have thick tumors and ulcerated tumors, would be good candidates for adjuvant therapy because of their risk profile. There will be an interesting immunotherapy trial for these patients, starting pretty soon, using pembrolizumab versus placebo in the adjuvant setting. The other important thing for this patient population is to look at biomarkers, moving forward. We need to try to identify better biomarkers to identify which patients are most likely to relapse and have biomarkers that would predict response to specific therapies beyond a BRAF mutation.

So, this is what we’re looking for in the long-term—better markers to identify risk for relapse. Therefore, we can target these therapies to the highest-risk patient population and spare the patients who are already cured any potential toxicity. And then, predictors of response to therapy will help us decide which therapy to use, whether it’s immunotherapy-based, or targeted therapy, or, maybe in the future, a combination of those 2, together.

Transcript Edited for Clarity 

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Transcript: 

Merrick I. Ross, MD: It’s really an exciting time for patients who have melanoma, particularly the high-risk patient population. It’s also very exciting for the treating physicians because we have great options for patients. There has really been a revolution in both the stage 4 and adjuvant settings. The next group of trials will look at high-risk patients, but in a different setting. The high-risk stage 2 patients who don’t have lymph node involvement, particularly if they have thick tumors and ulcerated tumors, would be good candidates for adjuvant therapy because of their risk profile. There will be an interesting immunotherapy trial for these patients, starting pretty soon, using pembrolizumab versus placebo in the adjuvant setting. The other important thing for this patient population is to look at biomarkers, moving forward. We need to try to identify better biomarkers to identify which patients are most likely to relapse and have biomarkers that would predict response to specific therapies beyond a BRAF mutation.

So, this is what we’re looking for in the long-term—better markers to identify risk for relapse. Therefore, we can target these therapies to the highest-risk patient population and spare the patients who are already cured any potential toxicity. And then, predictors of response to therapy will help us decide which therapy to use, whether it’s immunotherapy-based, or targeted therapy, or, maybe in the future, a combination of those 2, together.

Transcript Edited for Clarity 
View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Medical Crossfire®: Evolving Roles for Targeted Melanoma Therapies: Assessing Rapid Progress in the Field and Looking Toward Future CombinationsFeb 28, 20191.5
Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant SettingsSep 28, 20191.5
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