The most important thing is probably the need for better biomarkers. Imagine how good these survival curves would be for the immunotherapeutic agents if we had very good markers to say who is inherently resistant to immunotherapy, or who is likely to acquire resistance to therapy. We could develop alternative therapies instead of going into something that we know they probably won't respond to. If there are patients who are BRAF
wild type, who have markers to suggest no response to immunotherapy, and have disease that is resectable, maybe those patients should have surgery. There may be markers, or gene expression profiles within the primary tumor, even for patients that have metastatic disease. If we go back and look at their primary, we may find a signature that may be useful to predict favorable outcome from a surgical approach. I think the future challenge is to establish really good biomarkers.
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