It was just 6 years ago that options for patients with metastatic melanoma began to expand. In 2011, the approval of ipilimumab (Yervoy), the pioneering checkpoint immunotherapy for patients with unresectable or metastatic disease, marked the first milestone. Clinicians treating patients with advanced melanoma now have a toolkit that is stocked with several types of immunotherapies and targeted therapies.
Researchers, faced with so many new options, are trying to answer the question of whether these agents can be leveraged earlier in the treatment timeline to prevent or delay metastases. Adjuvant therapy has become a mainstay in other malignancies, notably breast cancer, but it is not assured that a similar approach would work as well in melanoma.
Now the results of 2 clinical trials, presented at the 2017 European Society for Medical Oncology Annual Congress, set the stage for a new era in melanoma treatment. Our cover story in this issue of OncologyLive®
, “New Adjuvant Therapy Era Builds in Melanoma,” details the topline ndings of 2 phase III trials in the adjuvant setting: single-agent nivolumab (Opdivo) and the combination of dabrafenib (Tafinlar) and trametinib (Mekinist) for patients with a BRAF
mutation. We are at the beginning of the discussion of which patients should be offered immunotherapy versus a targeted combination in the adjuvant setting.
The implications for patients are widespread. Most patients who present with de novo stage III melanoma have resectable disease. That means many of those who are deemed at high risk of recurrence—another area requiring further clarity—will be eligible for adjuvant therapy.
This is, indeed, an exciting prospect. Effective adjuvant treatment may result in the prevention of metastatic disease, or at least a clinically meaningful delay in the progression to a more advanced state.
We will be looking for opportunities to report developments in this crucial area of oncology research as soon as they occur. As always, thank you for reading.