Victoria Atkinson, MD, medical oncologist, Princess Alexandra Hospital, University of Queensland, discusses the treatment landscape for patients with BRAF-mutant metastatic melanoma.

We have come a long way in a short period of time, says Atkinson. If a patient has 

-mutant melanoma, they can be treated with targeted therapy and immunotherapy. The median overall survival (OS) with immunotherapy is 38 months and the OS with targeted therapy is 25.8 months.

According to Atkinson, there is enthusiasm from clinicians to look for better checkpoints inhibitors to have long-term disease control and cure.

Videos

Dr. Atkinson Discusses BRAF-Mutant Metastatic Melanoma

Victoria Atkinson, MD, medical oncologist, Princess Alexandra Hospital, University of Queensland, discusses novel combinations for the treatment of patients with melanoma.

According to Atkinson, there are many novel ideas and combinations including talimogene laherparepvec (T-VEC; Imlygic) and injecting plasmas.

Additionally, the combination of LAG3 and PD-1 will have phase III results released early next year, explains Atkinson. Other combinations include IDO inhibitors with PD-1, which has potential to improve response and reduce toxicity.

Dr. Atkinson on Novel Combinations in Melanoma

Victoria Atkinson, MD, medical oncologist, Princess Alexandra Hospital, University of Queensland, discusses the COLUMBUS trial for patients with melanoma.

The COLUMBUS trial investigates the combination of encorafenib and binimetinib. Patients who received encorafenib and binimetinib experienced less photosensitivity and rash, which has been seen with the vemurafenib (Zelboraf) and cobimetinib (Cotellic) compounds, states Atkinson.

The COLUMBUS data are unique since it uses the highest dose of a BRAF inhibitor. This is done in the hopes to have the maximum blockade of the MAP-kinase pathway, explains Atkinson. This trial has seen the longest progression-free survival of targeted therapies.

View more from the World Congress of Melanoma

Victoria Atkinson, MD, medical oncologist, Princess Alexandra Hospital, University of Queensland, discusses the Columbus trial for patients with melanoma.

Dr. Atkinson Discusses the COLUMBUS Trial for Melanoma

Victoria Atkinson, MD, of Princess Alexandra Hospital and Gallipoli Medical Research Foundation, Queensland, discusses long-term data from the phase III CheckMate-066 trial.

The trial looked at nivolumab alone or in combination with ipilimumab as a frontline treatment for patients with advanced melanoma. Both nivolumab alone and the combination improved survival when compared to dacarbazine.

To determine if patients should receive the combination or nivolumab alone, it is important to consider patient characteristics, says Atkinson. Patients who have a low burden of disease, who are more frail, or do not require a rapid response, should receive nivolumab alone, she explains. As a monotherapy nivolumab is well-tolerated with a response rate of over 40%.

Patients who need a rapid response should receive combination therapy, says Atkinson.

Victoria Atkinson, MD

Articles

Dr. Atkinson Discusses BRAF-Mutant Metastatic Melanoma

Dr. Atkinson on Novel Combinations in Melanoma

Dr. Atkinson Discusses the COLUMBUS Trial for Melanoma

Dr. Atkinson on When to Use Nivolumab Monotherapy Versus Nivolumab/Ipilimumab Combination