Dr. Johnson on Applications of Immunotherapy in Melanoma

Douglas B. Johnson, MD, assistant professor of medicine, Vanderbilt University Medical Center, clinical director, Melanoma Research Program, Vanderbilt-Ingram Cancer Center, discusses applications of immunotherapy in melanoma.

Immunotherapy is widely used in the treatment of patients with melanoma, both as a single agent and in combination, Johnson says. This modality is now utilized in the adjuvant setting, specifically anti—PD-1 therapy for patients with high-risk stage III disease. Physicians use single-agent nivolumab (Opdivo) or pembrolizumab (Keytruda) following surgical resection, decreasing the risk of recurrence by about 50%, Johnson notes.

In the metastatic setting, physicians can choose between single agent anti—PD-1 therapy or a combination of nivolumab and ipilimumab (Yervoy). This therapy is yielding long-term survival in approximately 40% to 55% of patients with metastatic disease, says Johnson. Another application of immunotherapy is in patients with brain metastases. A recent phase II study showed promising response rates with combination immunotherapy in patients with asymptomatic brain metastases, Johnson adds.