Helen Heng-Shan Moon, MD, hematologist, oncologist, Kaiser Permanente Riverside Medical Center, discusses the future of care in prostate cancer.

Because receiving a prostate cancer diagnosis can still carry a negative connotation, it is important to explain to patients that there are treatment options and ways to support their quality of life and prolong survival, Moon explains. Frontline treatment intensification for patients with prostate cancer has provided encouraging data and should be utilized in clinical practice, Moon says.

Further, recommending patients for clinical trials can also be beneficial, Moon continues. Prior clinical trials improved treatment for prostate cancer, and future studies will help introduce new options, Moon concludes.

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Helen Heng-Shan Moon, MD, discusses the future of care in prostate cancer.


Dr. Moon on the Future of Care in Prostate Cancer

Helen Heng-Shan Moon, MD, hematologist, oncologist, Kaiser Permanente Riverside Medical Center, discusses the utilization of relatlimab plus nivolumab (Opdualag) in patients with unresectable or metastatic melanoma.

The phase 2/3 RELATIVITY-047 trial (NCT03470922) examined if relatlimab in combination with nivolumab is more effective than nivolumab monotherapy in metastatic melanoma. In March 2022, the FDA approved relatlimab plus nivolumab for the treatment of patients 12 years of age and older with unresectable or metastatic melanoma.

Notably, overall survival was not a primary endpoint of the trial, which is important to keep in mind when evaluating the data, Moon says. One of the questions still surrounding the combination of relatlimab and nivolumab is its efficacy in patients with central nervous system (CNS) metastases, since patients with melanoma are susceptible to CNS metastases, Moon notes. Prior data have shown nivolumab and ipilimumab (Yervoy) have activity in patients with CNS metastases, so further evaluation will be needed to examine how relatlimab and nivolumab perform in that subgroup of patients, Moon adds.

While it is important to have relatlimab and nivolumab as an option for patients, Moon explains she is not ready to say whether relatlimab and nivolumab will replace nivolumab and ipilimumab as the preferred combination for patients with metastatic melanoma.

Helen Heng-Shan Moon, MD, discusses the utilization of relatlimab plus nivolumab in patients with unresectable or metastatic melanoma.


Dr. Moon on the Utilization of Relatlimab Plus Nivolumab in Metastatic Melanoma

Helen Heng-Shan Moon, MD, hematologist, oncologist, Kaiser Permanente Riverside Medical Center, discusses the role of PARP inhibitors in prostate cancer.

Patients with sensitizing mutations should be considered for treatment with PARP inhibitors, Moon says. However, a barrier still exists since not all patients with prostate cancer have access to or are offered testing for sensitizing mutations, Moon notes.

The phase 3 MAGNITUDE trial (NCT03748641) demonstrated the use of the PARP inhibitor niraparib (Zejula) in combination with abiraterone acetate (Zytiga) can improve progression-free survival for patients with metastatic castration-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) gene alterations, and these data have held up with follow-up, Moon continues. Notably, the phase 3 PROpel trial (NCT03732820) showed olaparib (Lynparza) plus abiraterone improved PFS, except the trial allowed patients with or without HRR gene alterations, Moon adds.

Data from PROpel raised the question if the prostate cancer field is ready to offer PARP inhibitors to patients without sensitizing mutations, Moon says. Olaparib is currently approved for patients with HRR gene-mutated mCRPC who progressed following prior treatment with enzalutamide (Xtandi) or abiraterone, and it will be interesting to see if it can be moved into an earlier treatment setting, Moon concludes.

Helen Heng-Shan Moon, MD, discusses the role of PARP inhibitors in prostate cancer.


Dr. Moon on the Role of PARP Inhibitors in Prostate Cancer

Helen Heng-Shan Moon, MD, hematologist, oncologist, Kaiser Permanente Riverside Medical Center, discusses the FDA approval of relatlimab plus nivolumab (Opdualag) in patients with unresectable or metastatic melanoma.

In March of 2022, the FDA approved the fixed-dose combination of relatlimab plus nivolumab in adult and pediatric patients 12 years of age and older with unresectable or metastatic melanoma.

Combination ipilimumab (Yervoy) and nivolumab is currently offered for patients with advanced melanoma, though this regimen can produce high-grade adverse effects (AEs), Moon says. Nivolumab monotherapy can be recommended for patients who may not tolerate the AEs associated with the combination, despite the single agent being inferior to the combination therapy, Moon explains.

The FDA approval of relatlimab and nivolumab provides another combination option for this patient population, Moon continues. It is difficult to compare the efficacy of the 2 combinations without a head-to-head trial; however, the relatlimab plus nivolumab represents a safer treatment option in terms of AEs, Moon adds.

Relatlimab plus nivolumab is now an alternative doublet for patients with metastatic melanoma who would have been candidates for single-agent nivolumab, Moon concludes.

Helen Heng-Shan Moon, MD, discusses the FDA approval of relatlimab plus nivolumab in patients with unresectable or metastatic melanoma.

Helen Heng-Shan Moon, MD

Articles

Dr. Moon on the Future of Care in Prostate Cancer

Dr. Moon on the Utilization of Relatlimab Plus Nivolumab in Metastatic Melanoma

Dr. Moon on the Role of PARP Inhibitors in Prostate Cancer

Dr. Moon on the FDA Approval of Relatlimab Plus Nivolumab in Metastatic Melanoma