Unmet Needs and Future Treatments of Metastatic Melanoma

Source: OncLive, September 2019

The big problem in melanoma continues to be the fact that resistance develops so often to these treatments. And for the BRAF and MEK inhibitors, although these long-term data are reassuring, we know that patients who have complete responses, who don’t have LDH [lactate dehydrogenase] elevations, who are on limited types of diseases will do well. Many of our patients have extensive sites of disease, many of patients have elevated LDH, many of our patients will not have a complete response. So where do we go with those folks?

I think the 1 interesting direction is the combination where immunotherapy and BRAF/MEK inhibitors are combined altogether, where there have been 3 trials. Most of them have been small, showing some benefit in terms of combining all 3, and there are some large, randomized phase III trials ongoing to look and see whether that benefit is prolonged and that benefit is statistically and clinically significant.

I think other interesting directions that people are going in are looking at different drugs, looking at drugs like ERK inhibitors, looking at PI3 kinase inhibitors, where people think that those might be able to face all resistance or might hold off resistance…