Role of Single-Agent vs Dual IO Evolves in Metastatic Melanoma
Source: Targeted Oncology, November 2023
The role of immunotherapy continues to evolve for the treatment of patients with skin cancer, now with physicians able to choose between the use of single-agent vs dual immunotherapy treatments. In 2 separate Case-Based Roundtable events led by Alan Tan, MD, and Douglas B. Johnson, MD, MSCI, physicians considered these options for a patient with metastatic melanoma.
FOR MANY PATIENTS with metastatic or unresectable melanoma, immune checkpoint inhibition (ICI) is the preferred frontline treatment option based on favorable efficacy and tolerability in this setting. However, now that multiple immunotherapy (IO) agents have been approved, considerations related to efficacy, tolerability, and administration influence how physicians use these agents.
Preferred first-line options include single-agent nivolumab (Opdivo) and pembrolizumab (Keytruda) as well as combination nivolumab plus ipilimumab (Yervoy), and most recently the combination of nivolumab plus relatlimab (Opdualag).1 Nivolumab plus ipilimumab has demonstrated superior efficacy vs single-agent nivolumab, but combination regimens come with added toxicity of immune-related adverse events (irAEs) such as pneumonitis, colitis, and atrial fibrillation that can be serious and lead to discontinuation of one or both [treatments].2