Focus Moves to Earlier Settings in Melanoma

Source: OncLive, February 2018

Novel systemic therapies in the neoadjuvant and adjuvant settings have shown promising outcomes for locally advanced melanoma and may reduce the proportion of patients who need complete lymphadenectomy. Optimizing systemic therapy to maximize efficiency and minimize adverse events (AEs) will be the next step moving forward, according to panelists who participated in an OncLive Peer Exchange® panel.
The panelists discussed recent clinical trial results showing high rates of pathologic response with neoadjuvant therapy that targets BRAF and MEK and agents that modulate the immune system, lack of improvement in overall survival (OS) with complete lymphnode dissection for sentinel node metastases, and substantial improvements in relapsefree survival (RFS) with adjuvant BRAF- plus MEK-targeted therapy and PD-1 targeted therapy. Although the panelists agreed that systemic therapy should play a key role in the treatment of locally advanced disease, determining the optimal agents and duration of therapy will require head-to-head trials comparing the regimens. Effective treatment approaches also will involve combinations of agents, according to Axel Hauschild, MD, PhD.
The trend in melanoma therapy has been toward combinations, and Hauschild said he expects that to continue. Sequencing drugs correctly will be important, he noted.