Dr Moser on Treatment Considerations After Progression on Frontline PD-1 Inhibitors in Melanoma
Source: OncLive, May 2025
Justin Moser, MD, a medical oncologist at HonorHealth and an associate clinical investigator at HonorHealth Research Institute, discussed therapeutic decision-making for patients with advanced melanoma who progress following initial treatment with checkpoint inhibitor–based combinations, such as nivolumab (Opdivo) plus ipilimumab (Yervoy) or nivolumab plus relatlimab-rmbw (Opdualag).
A major clinical challenge in this setting is that most FDA-approved regimens are indicated in the frontline setting, leaving limited guidance or prospective data to inform second-line strategies, Moser began. For patients without a BRAF mutation, the most accessible second-line options remain other checkpoint inhibitor combinations, Moser stated. However, the utility of these regimens is highly dependent on the patient’s initial response to immunotherapy, Moser stated.
Retrospective data suggest that patients who achieve a clinical benefit—such as partial response, complete response, or prolonged disease stability—before developing resistance to first-line checkpoint blockade have an approximately 30% to 33% chance of responding to a different checkpoint combination in the second-line setting, Moser stated. In these cases, re-challenging with another immunotherapy combination may be reasonable, particularly if the initial benefit was durable, Moser stated.