Dr. Saenger on Combining Targeted and Immune Agents

Yvonne M. Saenger, MD, Assistant Professor in Medicine and Dermatology, Hematology and Medical Oncology, Mount Sinai School of Medicine, discusses the idea of combining targeted and immune agents.

It is very attractive to combine these two types of agents, Saenger says, as targeted agents knock down the tumor burden; however, they generally do not produce long term responses. Additionally, when a large tumor is present, a patient is less likely to respond to immunotherapy, as the tumor is generally immunosuppressive.

The concept behind the phase II CA184-240 study in advanced melanoma is to hit the tumor with vemurafenib, a BRAF inhibitor, then administer ipilimumab, an CTLA-4-targeted immunotherapy. However, unfortunately, a previous trial using these drugs simultaneously demonstrated liver toxicity.

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