Dr Petrella on Selecting Frontline Therapy in Metastatic Melanoma
Source: OncLive, February 2025
Teresa Petrella, MD, MHSc, FRCPC, medical oncologist, affiliate scientist, Evaluative Clinical Sciences, Odette Cancer Research Program, Sunnybrook Research Institute; and associate professor, Department of Medicine, University of Toronto, discusses key considerations in selecting frontline therapy for patients with metastatic melanoma based on long-term survival data and therapeutic sequencing findings.
Over the past decade, multiple studies have evaluated the efficacy of combination immunotherapy with nivolumab (Opdivo) and ipilimumab (Yervoy) compared with single-agent checkpoint inhibitors. Updated 10-year results from the phase 3 CheckMate 067 trial (NCT01844505) continue to demonstrate a survival benefit with combination therapy, with overall survival (OS) rates of 43% for nivolumab plus ipilimumab, 37% for nivolumab monotherapy, and 19% for ipilimumab monotherapy. Petrella notes that these findings indicate that the benefit of combination therapy remains durable beyond the 3-year mark.
Beyond treatment with CTLA-4 and PD-1 blockade, Petrella explains that data from the phase 2/3 RELATIVITY-047 trial (NCT03470922)of nivolumab plus relatlimab-rmbw (Opdualag), a LAG-3 inhibitor, demonstrated a progression-free survival (PFS) advantage vs nivolumab alone in this patient population (HR, 0.79; 95% CI, 0.66-0.95). Investigators observed a trend in favor of the combination for OS (HR, 0.80; 95% CI, 0.66-0.99), with 3-year OS rates of 55% (95% CI, 49.2%-59.6%) and 48% (95% CI, 42.7%-53.1%), respectively.