The New Horizon in Melanoma

Source: OncLive, January 2020

Early in this decade, Jeffrey S. Weber, MD, PhD, saw how well nivolumab (Opdivo) performed against advanced melanoma and recognized a good thing. He had a hunch the PD-1 inhibitor would reduce relapse rates by stimulating immune response against any cancer cells that escaped the surgeon’s knife.

Weber urged the drug’s developer, BristolMyers Squibb (BMS), to launch a trial of nivolumab in the adjuvant setting for patients with newly resected stage III or IV melanoma, but BMS officials were skeptical. They thought the drug was unlikely to work in the absence of a tumor microenvironment and were unwilling to fund trials.

In most cases, such a refusal would have prevented investigation, but Weber, a 2016 Giants of Cancer Care® award winner, thought the chance to significantly lower relapse rates justified an independent pilot study. He secured the funding, the pilot took place, and the results led BMS to launch the CheckMate 238 trial (NCT02388906) of adjuvant immunotherapy with nivolumab versus ipilimumab (Yervoy) in patients with resected advanced melanoma.1 The trial was positive and earned nivolumab an FDA approval in this setting in 2017. Adjuvant treatment with nivolumab or the PD-1 inhibitor pembrolizumab (Keytruda) is now a standard of care (SOC) in patients with newly resected stage III or IV melanoma.

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