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Merkel cell carcinoma has a high rate of metastasis and poor patient outcomes. The current standard of care for patients with recurrent, unresectable, or metastatic disease is immune checkpoint inhibitor monotherapy targeting PD-1 and PD-L1, but only about half of patients respond to this therapy....
In an international, multicenter phase II clinical trial, 63.3% of patients with stage II to IV cutaneous squamous cell carcinoma saw their tumors nearly or completely eradicated when treated with the anti–PD-1 agent cemiplimab-rwlc before surgery. The results were presented by Gross et al at the...
Patients with high-risk melanoma who received the anti–PD-1 therapy pembrolizumab both before and after surgery to remove cancerous tissue had a significantly lower risk of their cancer recurring than similar patients who received the drug only after surgery. These results from a study by the SWOG...
Sapna P. Patel, MD, of The University of Texas MD Anderson Cancer Center, discusses the latest findings from the SWOG S1801 trial, which showed that using single-agent pembrolizumab as neoadjuvant therapy improved event-free survival compared to adjuvant therapy in high-risk resectable stage III–IV melanoma (Abstract LBA6).
A novel treatment strategy with personalized cell therapy significantly improved progression-free survival compared to standard immunotherapy in patients with advanced melanoma, according to results from the phase III M14TIL trial reported by John Haanen, MD, PhD, and colleagues at the European...
People with light skin tones are far more likely to develop melanoma than people with darker skin tones. This large disparity results from far more than can be explained by the ultraviolet (UV) protective effects of melanin pigment, owing in large part to the melanin precursor...
As reported in the Journal of Clinical Oncology by Chesney et al, the phase III MASTERKEY-265 trial has shown no significant improvement in progression-free survival or overall survival with the addition of talimogene laherparepvec (T-VEC) to pembrolizumab in patients with advanced melanoma. Study...
Ultraviolet (UV) protection from the sun and avoiding indoor tanning play important roles in reducing a person’s risk for skin cancer, the most common cancer in the United States and one of the most preventable. A recent article published by Yang et al in the Journal of the American Academy of...
In the phase II TRICOTEL study reported in The Lancet Oncology, Reinhard Dummer, MD, and colleagues found that the combination of atezolizumab plus vemurafenib and cobimetinib produced durable intracranial responses in patients with BRAF V600–mutated melanoma and central nervous system (CNS)...
In an analysis of the Multicenter Selective Lymphadenectomy Trial II reported in JAMA Surgery, Crystal et al found that patients with melanoma with sentinel lymph node (SLN) metastasis who were randomly assigned to observation vs completion lymph node dissection (CLND) following SLN biopsy...
In a 5-year update of part 1 of the phase III COLUMBUS trial reported in the Journal of Clinical Oncology, Dummer et al found a continued benefit of encorafenib plus binimetinib vs vemurafenib in patients with advanced BRAF V600–mutant melanoma. The trial supported the June 2018 approval of...
In the phase II LEAP-004 trial reported in Journal of Clinical Oncology, Arance et al found that the combination of lenvatinib and pembrolizumab was active in patients with advanced melanoma with confirmed progression on PD-1/PD-L1 inhibitors as monotherapy or in combination with other agents. As...
In a study reported in the Journal of Clinical Oncology, Moncrieff et al found that patients with stage IIIA melanoma (per American Joint Committee on Cancer [AJCC], 8th edition) with sentinel node metastatic tumor deposits ≥ 0.3 mm are at higher risk of disease progression vs those with smaller...
In a Dutch trial reported in The Lancet Oncology, Adan et al found that optical coherence tomography (OCT)-guided diagnosis and treatment of basal cell carcinoma was noninferior to that with punch biopsy, currently the guideline-recommended standard for diagnosis and treatment. Study Details In the ...
Assessing the thickness of melanoma is difficult—whether done by an experienced dermatologist or a well-trained machine-learning algorithm. A study published by Polesie et al in the Journal of the European Academy of Dermatology and Venereology showed that an algorithm and a group of approximately...
Diagnosing melanoma clinically and under the microscope can be complicated by the presence of melanocytic nevi, otherwise known as birthmarks or moles that are noncancerous. The development of melanoma is a multistep process, where melanocytes mutate and proliferate. Properly identifying melanoma...
A rapid update to the ASCO guideline on systemic therapy for melanoma adds a new recommendation for the treatment of patients with metastatic uveal melanoma.1 The update follows the January 2022 U.S. Food and Drug Administration (FDA) approval of tebentafusp-tebn for patients with previously...
In this installment of The ASCO Post’s Global Oncology series, Guest Editor Chandrakanth Are, MBBS, MBA, FRCS, FACS, spoke with surgical oncologist Héctor Martínez-Said, MD, of the Melanoma Clinic at NCI Mexico. Dr. Martínez-Said’s maternal grandfather was part of a Lebanese immigration movement...
Androgen receptor (AR) signaling may affect response to BRAF/MEK inhibitor therapy in both male and female patients with melanoma, according to findings from a study published by Vellano et al in Nature. The report provides a new target to combat therapeutic resistance and one possible answer to...
Georgina V. Long, MD, PhD, of the Melanoma Institute Australia, The University of Sydney, discusses phase III findings from the KEYNOTE-716 study. The trial showed that compared with placebo, adjuvant pembrolizumab significantly improved distant metastasis–free survival in patients with resected stage IIB and IIC melanoma. The findings also suggest a continued reduction in the risk of recurrence and a favorable benefit-risk profile (Abstract LBA9500).
Georgina V. Long, MD, PhD, of the Melanoma Institute Australia, The University of Sydney, discusses findings from the NeoTrio trial on neoadjuvant pembrolizumab alone, in sequence with, or concurrent with dabrafenib plus trametinib in patients with resectable BRAF-mutant stage III melanoma. The study may help clinicians determine the optimal combination of therapy (Abstract 9503).
Invited study discussant of the use of ipilimumab plus nivolumab in resistant melanoma, at the AACR Annual Meeting 2022, Mario Sznol, MD, of Yale University Cancer Center, indicated that the substantial increase in progression-free survival at 6 months was not maintained. “The durable...
A sizable proportion of patients with advanced melanoma will experience disease progression on anti–PD-1 therapy, and the optimal treatment of such patients represents an unmet need. Two studies presented at the American Association for Cancer Research (AACR) Annual Meeting 2022 explored separate...
In a study reported as a letter to the editor in The New England Journal of Medicine, Alexander M. Menzies, MD, and colleagues found that patients with metastatic melanoma who had progressive disease while receiving relatlimab/nivolumab had poor responses to anti–CTLA-4–based treatment. As noted...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On March 18, 2022, fixed-dose nivolumab and...
A novel immunotherapeutic combination that targets PD-1 and the LAG-3 pathway significantly delayed disease progression as a first-line treatment of advanced or unresectable melanoma. Updated results of the global phase III RELATIVITY-047 trial validated the study’s initial findings and were...
Genevieve Boland, MD, PhD, of Massachusetts General Hospital Cancer Center, discusses targeted treatments and immunotherapies and how they have dramatically changed the landscape in melanoma. Initially used in advanced disease, these agents are now being used in local or locoregional melanoma in the adjuvant and/or neoadjuvant settings. Dr. Boland also talks about the critical importance of multidisciplinary teams to integrate the latest recommendations for patient care.
In a single-center study reported in JCO Oncology Practice, Ceballos et al identified turnaround times for request and receipt of melanoma BRAF testing results. They also analyzed factors in differences in turnaround times and effects on time to initiation of treatment. The study included 66...
Patients with advanced melanoma whose cancer does not respond to treatment with PD-1 inhibitors are often switched to treatment with a second type of immunotherapy drug, a CTLA-4 inhibitor such as the drug ipilimumab. In a phase II trial presented by Vanderwalde et al during the American...
As reported in The Lancet by Luke et al, the phase III KEYNOTE-716 trial has shown significantly prolonged recurrence-free survival with adjuvant pembrolizumab vs placebo in patients with high-risk completely resected stage IIB/IIC melanoma at both first and second interim analyses. The first...
Iván Márquez-Rodas, MD, PhD, of Spain’s Hospital General Universitario Gregorio Marañón, discusses final results of the phase II SPOTLIGHT203 study of systemic pembrolizumab in combination with intratumoral BO-112 for patients with advanced melanoma refractory to anti–PD-1–based therapy. The regimen achieved an overall response rate of 25% and a disease control rate of 65% (Abstract CT014).
Ari M. VanderWalde, MD, MPH, MBioeth, of The West Clinic, discusses results from the S1616 trial involving patients with metastatic or unresectable melanoma who had primary resistance to PD-1 or PD-L1 inhibitors. Compared with ipilimumab alone, the combination of ipilimumab plus nivolumab benefited some patients: those with tumors that responded to therapy showed an increased amount of CD8+ cells. Because there is no standard treatment for metastatic melanoma after failure of PD-1 inhibitors in BRAF wild-type disease, this research may provide a viable option in the future (Abstract CT013).
In the recently published results of the RELATIVITY-047 trial,1 summarized in this issue of The ASCO Post, the addition of relatlimab to nivolumab monotherapy was associated with improved progression-free survival compared with nivolumab alone in patients with previously untreated advanced,...
In a phase II/III trial (RELATIVITY-047) reported in The New England Journal of Medicine, Hussein A. Tawbi, MD, PhD, of The University of Texas MD Anderson Cancer Center, and colleagues found that the addition of relatlimab, a lymphocyte-activation gene 3 (LAG-3)–blocking antibody, to nivolumab...
In a population-based cohort study reported in JAMA Network Open, Schonfeld et al identified the incidence of immune-related adverse events among White patients aged ≥ 65 years with newly diagnosed melanoma treated with immune checkpoint inhibitors. They compared the risk of these adverse events...
In a population-based cohort study reported in JAMA Oncology, Chen et al found that the incidence of overall cutaneous melanoma and thinner tumors was stable in the United States from 2010 to 2018, with an increased incidence of the thickest (T4) melanomas being observed. Lower socioeconomic status ...
On March 18, the U.S. Food and Drug Administration (FDA) approved nivolumab and relatlimab-rmbw (Opdualag) for adult and pediatric patients 12 years of age or older with unresectable or metastatic melanoma. The approved treatment is a fixed-dose combination of the LAG-3–blocking antibody relatlimab ...
A novel immunotherapeutic combination that targets PD-1 and the LAG-3 pathway may significantly delay disease progression as a first-line treatment of advanced or unresectable melanoma. Updated results of the global phase III RELATIVITY-047 trial validated the study’s initial findings and were...
Intratumor injection of the oncolytic virus RP1 in combination with the checkpoint inhibitor nivolumab has demonstrated durable antitumor activity in patients with nonmelanoma skin cancer of the head and neck, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers...
In a retrospective analysis reported in JAMA Surgery, Reijers et al found that pathologic response in largest lymph node metastasis (index lymph node [ILN]) was highly concordant with response in the total lymph node bed in patients with stage III melanoma receiving neoadjuvant...
Patients treated for Merkel cell carcinoma face a 5-year recurrence rate of 40%—markedly higher than the recurrence rates for melanoma and other skin cancers, according to research published by McEvoy et al in JAMA Dermatology. Additionally, in the study cohort of more than 600 patients, 95% of...
In a study reported in the Journal of Clinical Oncology, Pires da Silva et al developed predictive models for objective response and progression-free and overall survival among patients receiving anti–PD-1 antibodies with or without ipilimumab for metastatic melanoma. The analyses involved data...
On January 25, 2022, tebentafusp-tebn, a bispecific gp100 peptide-HLA–directed CD3 T-cell engager, was approved for treatment of adults with HLA-A*02:01–positive, unresectable or metastatic uveal melanoma.1 Supporting Efficacy Data Approval was based on findings in the open-label, multicenter...
Melanoma is often curable when detected and treated in its early stages. However, the disease can rapidly spread to other organs in the body and become deadly. Immune checkpoint inhibitors have transformed the treatment of certain cancers, including melanoma, and improved patient care. But despite...
In a Danish retrospective study reported in the International Journal of Cancer, Ellebaek et al found that patients with advanced melanoma responding to PD-1 inhibitor therapy who stopped treatment within 18 months had improved survival outcomes when fluorodeoxyglucose (F-18) positron-emission...
As reported in the Journal of Oncology by Reinhard Dummer, MD, and colleagues, the phase III COMBI-i trial has shown no significant progression-free survival benefit with the addition of the anti–PD-1 antibody spartalizumab to dabrafenib and trametinib in patients with no prior systemic treatment...
On January 26, the U.S. Food and Drug Administration (FDA) granted approval to tebentafusp-tebn (Kimmtrak) for the treatment of adult patients with HLA-A*02:01–positive, unresectable or metastatic uveal melanoma. Tebentafusp’s approval establishes several firsts: as the first T-cell receptor...
On December 3, 2021, pembrolizumab was approved for adjuvant treatment of adult and pediatric (≥ 12 years of age) patients with stage IIB or IIC melanoma following complete resection.1 Supporting Efficacy Data Approval was based on findings in the phase III, double-blind KEYNOTE-716 trial...
After almost a century of limited efficacy of cancer immunotherapy,1 the breakthrough happened in 2012 with the discovery of immune checkpoint inhibitors,2,3 leading to the 2018 Nobel Prize in Physiology or Medicine for James P. Allison and Tasuku Honjo. Yet about 40% of patients on immune...
In a single-institution study reported in The Lancet Oncology, David C. Qian, MD, PhD, and Zachary S. Buchwald, MD, PhD, of Winship Cancer Institute of Emory University, Atlanta, and colleagues found that patients with metastatic melanoma who received at least 20% of immune checkpoint inhibitor...