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Melanoma is growing in incidence and more emphasis needs to be placed on prevention, particularly in people at high risk, says Robert Andtbacka, MD. For patients diagnosed with melanoma, a better understanding of biomarkers for recurrence is needed, as is an understanding of how to use neoadjuvant immunotherapy to reduce the risk of recurrence, adds Andtbacka.
These are exciting times for patients and for treating physicians. Advances made with immunotherapy were paradigm-shifting, but do require getting used to a new set of side effects and a new set of mechanisms for treatment, according to Howard Kaufman, MD, who is currently president of the Society for Immunotherapy of Cancer (www.sitcancer.org), which he considers a great resource for physicians who want more information on managing patients with immunotherapeutic drugs. Videos, slide sets, and other useful educational materials are available for those who are contemplating using immunotherapies.
It’s never a good time to get melanoma, remarks Richard Joseph, MD; however, treatments today are a lot better than 5 or 6 years ago. The nature of treating melanoma has evolving rapidly, and oncologists are now able to offer new, promising therapies and real hope to patients, although many challenges remain. PD-1 inhibitors aren’t going to cure every patient; so the next question is what to do in those cases.
Other questions revolve around finding the balance between efficacy and toxicity when using combinations such as ipilimumab and nivolumab, and the best treatment approach for upfront therapy. Additionally, those who participate in clinical trials should be remembered, says Anna Pavlick, DO. Pavlick emphasizes that having novel therapies shouldn’t prevent physicians from enrolling patients in clinical trials and offering patients options that may be the best next step for them, since a cure is not yet available. A lot of work has been done in melanoma research, but there’s a lot more left to do, emphasizes Omid Hamid, MD.