Michael Atkins, MD
In the fast-moving world of melanoma treatment, new therapeutic options for patients with metastatic disease are emerging faster than oncology researchers can establish guidelines for their optimal clinical use. In less than 2 months last year, the FDA approved five new or expanded indications for drugs. As it stands now, the National Comprehensive Cancer Network (NCCN) has identified seven single or combination therapies for first-line treatment of metastatic or unresectable disease including three checkpoint immunotherapy agents and four targeted therapies (Table)
Despite making strong arguments for each viewpoint, both presenters and other leading researchers at the conference noted that questions about first-line systemic therapy for metastatic melanoma have not yet been fully resolved in clinical studies or by oncology experts. The NCCN is in the process of updating its guidelines—even though they were last revised in November 2015—and the Society for Immunotherapy of Cancer, which published the first consensus statement on the use of the emerging therapies in 2013, also is working on a new version.
The Case for Immunotherapy
Atkins, who helped pioneer the development of interleukin and interferon in melanoma treatment starting more than 20 years ago, argued that immunotherapy is the better choice for first-line treatment because of several factors.
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