Isabella C. Glitza Oliva, MD, PhD, MS, assistant professor, Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses ​the potential utility of pembrolizumab (Keytruda) in combination with selinexor ​(Xpovio) in advanced melanoma.

​During the 2020 ESMO Virtual Congress, initial findings from a phase 1b study (NCT02419495) ​showed significant clinical activity in patients with metastatic melanoma.

Notably, no new safety signals were observed​ with the combination, ​which allowed the study to meet its primary objective ​of safety and tolerability, ​Glitza Olivia explains. 

These findings warrant additional investigation with the combination. Moreover, the trial is evaluating selinexor in combination with various standard chemotherapy or immunotherapy regimens across multiple advanced malignancies.

Additionally, investigators are evaluating the triplet combination of ipilimumab (Yervoy), nivolumab (Opdivo), and selinexor in patients with melanoma and advanced solid malignancies, Glitza Olivia concludes.

Videos

Isabella C. Glitza Oliva, MD, PhD, MS, discusses ​the potential utility of pembrolizumab in combination with selinexor in advanced melanoma.








Dr. Glitza Olivia on the Potential Utility of Pembrolizumab/Selinexor in Advanced Melanoma

Isabella C. Glitza Oliva, MD, PhD, MS, an assistant professor within the Department of Melanoma Medical Oncology, Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses the prognosis of patients with melanoma brain and/or central nervous system (CNS) metastases.

Brain metastases or CNS metastases in melanoma have been a huge issue for many years. Of all the solid tumors, such as breast cancer, lung cancer, and colon cancer, melanoma has the highest likelihood of metastasizing or spreading to the CNS, including the brain and leptomeninges, says Glitza Olivia. Over the past 3 years, fantastic breakthroughs have been made in the treatment of patients with brain metastases, adds Glitza Olivia. However, patients whose disease spreads to the lining of the brain or spinal canal have a very poor prognosis and no therapies have been effective.

Historically, patients with melanoma who experience brain or CNS metastases typically only live a few weeks, although investigators from The University of Texas MD Anderson Cancer Center have recently reviewed the outcomes of patients with melanoma who have been treated at the institution over the years. Results showed that the overall survival of these patients was approximately 3.5 months, says Glitza Olivia. This is a patient population that has largely been ignored and for whom no great therapies are available, concludes Glitza Olivia.

Isabella C. Glitza Oliva, MD, PhD, MS, discusses the prognosis of patients with melanoma brain and/or central nervous system metastases.

Dr. Glitza Olivia on the Prognosis of Melanoma Brain Metastases

Isabella C. Glitza Oliva, MD, PhD, MS, assistant professor, Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the rationale for concurrent intrathecal (IT) and intravenous (IV) nivolumab (Opdivo) in patients with metastatic melanoma who have leptomeningeal disease.

IT interleukin-2 (IL-2) was used in metastatic melanoma prior to the advent of checkpoint inhibitors, says Glitza Oliva.

IL-2 administered by vein elicited prolonged survival in about 10% to 15% of patients with metastatic melanoma, says Glitza Oliva. However, IT IL-2 administered directly into the spinal fluid is associated with significant toxicities.

Single-agent nivolumab or pembrolizumab (Keytruda) have demonstrated better responses with less toxicity compared with IL-2 administered by vein, says Glitza Oliva.

As such, concurrent IV and IT nivolumab may have activity in metastatic melanoma, specifically for the subset of patients with leptomeningeal disease, concludes Glitza Oliva.

Isabella C. Glitza Oliva, MD, PhD, MS, discusses the rationale for concurrent intrathecal and intravenous nivolumab in patients with metastatic melanoma who have leptomeningeal disease.



Isabella C. Glitza Oliva, MD, PhD, MS

Articles

Dr. Glitza Olivia on the Potential Utility of Pembrolizumab/Selinexor in Advanced Melanoma

Dr. Glitza Olivia on the Prognosis of Melanoma Brain Metastases

Dr. Glitza Oliva on Intrathecal/Intravenous Nivolumab in Metastatic Melanoma/Leptomeningeal Disease