Deciding Between Melanoma Therapy Options

Source: OncLive, May 2023

Sunandana Chandra, MD, MS: To expound on that a bit more, Dr Pavlick, when you’re thinking of a combination immunotherapy approach for a patient, how do you decide between the 2 combinations that are FDA approved?

Anna C. Pavlick, MD: I would like to know that answer too. I think you need to look at the toxicity profile. If you’ve got someone who is ill or elderly or has multiple medical issues, whom you don’t think can tolerate a full dose of ipilimumab/nivolumab with a 50% toxicity risk but you’d like to offer them maybe a bit more than just a single-agent PD-1, you [may] want to give them PD-1 and relatlimab. It has a little higher toxicity profile than nivolumab alone, but it’s certainly not the same toxicity as ipilimumab/nivolumab. How do you pick? I think it is your patient assessment.

Sunandana Chandra, MD, MS: For patients who have BRAF mutations, you touched earlier on the potential to use triplet therapy. What are some of the scenarios where you would consider using a BRAF/MEK inhibitor as well as an anti–PD-1? To either of you;Dr Pavlick, how about you?