Melanoma

During the 2023 American Association for Cancer Research Annual Meeting, researchers presented results from a phase 2b clinical trial demonstrating significant improvement in recurrence-free survival in patients with high-risk melanoma who were treated with a combination of an investigational personalized mRNA-based vaccine plus the immune checkpoint inhibitor pembrolizumab (Keytruda), compared with pembrolizumab alone.

The addition of the lymphocyte activation gene-3 (LAG-3)–blocking antibody relatlimab to nivolumab (Opdivo) led to significantly longer progression-free survival (PFS) compared with nivolumab alone in previously untreated patients with advanced melanoma, according to results of the phase 3 RELATIVITY-047 clinical trial presented at the ASCO 2021 virtual annual meeting.

A real-world analysis showed that adjuvant immunotherapy in patients with stage III melanoma improved survival, but that only approximately 33% of eligible patients received such adjuvant therapy after ipilimumab (Yervoy) was approved by the FDA for this indication.

San Francisco, CA—Moving combination immunotherapy into the neoadjuvant setting for patients with stage III melanoma induces a higher rate of pathologic response than adjuvant therapy, said Christian U. Blank, MD, PhD, Division of Molecular Oncology & Immunology, Netherlands Cancer Institute, ­Amsterdam, at the 2019 ASCO-­SITC Clinical Immuno-Oncology Symposium.

When combined with systemic ipilimumab (Yervoy), the investigational oncolytic viral immunotherapy HF10, a mutation of the HF strain of the herpes simplex virus type 1 (HSV-1), has local and systemic activity in patients with metastatic melanoma, said Robert Andtbacka, MD, CM, Huntsman Cancer Institute, Salt Lake City, during a poster presentation at the 2016 American Society of Clinical Oncology meeting. He added that HF10 substantially improves the response rate of ipilimumab alone and does not exacerbate ipilimumab toxicity.

Evidence is mounting that 2 immunotherapies are better than 1 as first-line treatment of patients with advanced melanoma. A phase 3 clinical trial showed that nivolumab plus ipilimumab was superior to ipilimumab or nivolumab alone, and a phase 1 trial suggests that pembrolizumab can be safely and effectively used in combination with other drugs as first-line treatment in this setting. Both studies were presented at ASCO 2016.

More than 33% of patients with heavily pretreated advanced melanoma are still alive at 5 years after starting nivolumab (Opdivo) monotherapy, reported F. Stephen Hodi, Jr, MD, Director of the Melanoma Center, Dana-Farber Cancer Institute, Boston, at the 2016 American Association for Cancer Research (AACR) meeting.

“Intralesional therapy is here to stay,” said Sanjiv S. Agarwala, MD, Section Chief, Hematology/­Oncology, St Luke’s University Health Network, Easton, PA, who moderated a debate on this topic at the recent HemOnc Today Melanoma and Cutaneous Malignancies meeting.

Toronto, Ontario—BRAF protein expression is correlated with melanoma progression and poor patient survival, according to recent studies that were reviewed at the 2014 Canadian Dermatology Association annual conference.