Source: OncLive, May 2025
Although dual checkpoint inhibition remains the preferred frontline approach for patients with BRAF-mutated, advanced-stage melanoma, there is a significant need for effective treatment alternatives for those who are refractory to, ineligible for, or did not respond to standard checkpoint blockade or BRAF/MEK inhibitors, according to Vincent Ma, MD, who adds that a variety of ongoing clinical trials are exploring novel strategies to address this gap.
When managing patients who do not respond to or benefit from checkpoint inhibitors, BRAF/MEK targeted therapy should be considered in those with a BRAF V600 mutation, Ma explained. Additionally, the 2024 FDA approval of the tumor-infiltrating lymphocyte (TIL) therapy lifileucel (Amtagvi) as a third-line treatment for patients with BRAF mutations and a second-line option for broader melanoma populations represents a feasible treatment option for those who are sufficiently healthy and fit to tolerate next-line therapy. However, many patients may be ineligible for BRAF/MEK targeted therapy due to the absence of a BRAF mutation, Ma noted. Furthermore, many patients are not sufficiently healthy or fit enough for TIL therapy, which has its own logistical and biological challenges.