ESMO 2023: Expert Perspectives & Insights into the Testing and Treatment of Melanoma

A panel of experts discusses updates in metastatic melanoma biomarker testing and treatment presented at ESMO Congress 2023 and other recent meetings and reviews the data in the context of existing guidelines, the current treatment landscape, and its impact on clinical practice.

EP. 1: The Role of Biomarker Testing in the Management of Metastatic Melanoma

November 14th 2023

Expert panelists stress the importance of biomarker testing for BRAF mutations to guide treatment options when a patient is diagnosed with metastatic melanoma.

EP. 2: Best Practices for Biomarker Testing in Metastatic Melanoma

November 14th 2023

When a patient with metastatic melanoma patient tests negative for the BRAF V600E mutation, doctors recommend sending the sample for next-generation sequencing testing which can take 2-3 weeks, during which time they may start immunotherapy if the patient has aggressive disease, but ideally should wait for results to guide treatment.

EP. 3: Differences Between Community and Academic Settings Regarding Biomarker Testing Practices in Metastatic Melanoma

November 21st 2023

The panelists emphasize the importance of obtaining tissue for BRAF-mutation testing and dedicated tissue tracking in patients with metastatic melanoma, with immunohistochemistry followed by confirmatory next-generation sequencing, and discuss the promise of liquid biopsies like ctDNA as a future biomarker tracking modality.

EP. 4: Treatment Options for Patients With Metastatic Melanoma With a BRAF Mutation

November 21st 2023

For patients with BRAF-mutant metastatic melanoma, doctors assess symptoms and disease status to determine if they should start treatment with combination immunotherapy, or 8-12 weeks of BRAF/MEK targeted therapy before switching to immunotherapy, which offers the possibility of durable responses or cure.

EP. 5: Factors Influencing Treatment Decision-Making In Patients With BRAF-Mutated Metastatic Melanoma

November 30th 2023

Beyond symptoms, doctors consider the psychosocial factors impacting treatment access and adherence, like insurance coverage, cost, family support, and preexisting conditions, when deciding between immunotherapy and targeted therapy for patients with BRAF-mutated metastatic melanoma.

EP. 6: Frontline Treatment Options for Patients With BRAF-Mutated Metastatic Melanoma

November 30th 2023

Experts discuss a preference for ipilimumab/nivolumab as the frontline immunotherapy for patients with BRAF-mutant metastatic melanoma given its proven long-term efficacy but acknowledge nivolumab/relatlimab as an option with less toxicity, especially adrenal insufficiency.

EP. 7: Common Adverse Effects Seen With BRAF/MEK Inhibitor Therapy in Patients With BRAF-Mutated Metastatic Melanoma

December 7th 2023

Key opinion leaders explain that clinicians should warn patients with BRAF-mutated metastatic melanoma starting BRAF/MEK inhibitor therapy about short-term toxicities like fever, chills, and rash that can differ greatly from immunotherapy toxicities.

EP. 8: Choosing Between Available Combination BRAF/MEK Inhibitor Options for Patients With BRAF-Mutated Metastatic Melanoma

December 7th 2023

The panel explains which BRAF/MEK inhibitor combination therapy they each tend to turn to when treating a patient with BRAF-mutated metastatic melanoma.

EP. 9: Encorafenib Plus Binimetinib for BRAF-Mutated Metastatic Melanoma: 7-Year Follow-Up Data From the COLUMBUS Trial

December 14th 2023

The 7-year follow-up data for encorafenib/binimetinib showing that around 21% of patients remained progression-free supports BRAF/MEK inhibition as a later treatment option after immunotherapy failure, but doctors are reluctant to stop BRAF/MEK inhibitors given lack of data, even in those patients doing well long-term on the medications with minimal toxicity.

EP. 10: Efficacy and Safety of Rechallenge With BRAF/MEK Inhibitors in Patients With BRAF-Mutated Metastatic Melanoma

December 14th 2023

Panelists discuss the potential benefits of rechallenging patients with BRAF-mutated metastatic melanoma with BRAF/MEK inhibitors after a break from treatment, especially for those who initially responded well, and emphasizing the success of this approach in some cases, while highlighting the importance of monitoring and utilizing ctDNA tracking for more informed decision-making.

EP. 11: Treatment Approaches For Patients With BRAF-Mutated Melanoma and Asymptomatic Brain Metastases

December 21st 2023

For patients with BRAF-mutated melanoma with asymptomatic brain metastases, immunotherapy, particularly the combination of ipilimumab and nivolumab, is the preferred treatment option due to its effectiveness and durability, as supported by the seven-year follow-up data from the CHECKMATE 204 trial.

EP. 12: Treatment Approaches For Patients With BRAF-Mutated Melanoma and Symptomatic Brain Metastases

December 21st 2023

Experts discuss treatment of patients with BRAF-mutated melanoma and symptomatic brain metastases, detailing radiation therapy, corticosteroid use, and the choice between BRAF/MEK inhibitor therapy and immunotherapy.

EP. 13: Key Data on Combination Immunotherapies in BRAF-Mutated Melanoma with Brain Metastases

January 4th 2024

Doctors discuss the effectiveness of different treatment combinations for patients with BRAF-mutated metastatic melanoma and brain metastases, highlighting that consideration of patient preferences is essential in making treatment decisions.

EP. 14: The Future of Metastatic and Unresectable Melanoma Treatment

January 4th 2024

The panel concludes their discussion with a call for continued research and collaboration, emphasizing the need for more understanding of targeted therapies, monitoring tools like ctDNA, and ongoing development in the field of BRAF mutant melanoma treatment.