Emerging Triplet Regimens in Advanced Melanoma

Source: OncLive, February 2019


Axel Hauschild, MD: In 2019, we are expecting to see the results of 2 large, randomized clinical trials on triplet regimens, namely the BRAF and MEK inhibitors, plus a PD-1 [programmed cell death protein 1] antibody and a PD-L1 [programmed death-ligand 1] antibody, respectively. Specifically, we are looking forward to results of the TRILOGY trial and the COMBI-i trial. The TRILOGY trial looks at atezolizumab as a PD-L1 antibody plus vemurafenib and cobimetinib. The other one is spartalizumab, which was originally named PDR001, plus dabrafenib and trametinib. We don’t know the clinical trial results from the phase III trials, but we have smaller-sized phase I and II trials. At ESMO [European Society for Medical Oncology], there was a presentation that provided us a hint on thinking about the outcome of the triplet regimens compared with dual inhibition. Is anybody willing to talk about this, or should I summarize the data briefly? I’ll go ahead.

In the KEYNOTE-022 trial, the design was very simple. It was a randomized phase II trial with 60 patients in each group. One group received pembrolizumab plus dabrafenib and trametinib, and the other group received a matching placebo to pembrolizumab plus dabrafenib and trametinib. I need to mention that dabrafenib and trametinib were given at regular doses as approved for stage IV patients.


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