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PER® International Symposium on Melanoma and Other Cutaneous Malignancies

Paolo A. Ascierto, MD, director, Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, National Tumor Institute Fondazione G. Pascale, discusses treatment sequencing considerations for patients with advanced 

-mutant melanoma, based on findings from the phase 2 SECOMBIT (NCT02631447) and phase 3 DREAMseq (NCT02224781) trials.

Ascierto notes that each of these trials demonstrated improved overall survival when initiating treatment with immune checkpoint inhibitor–based therapy rather than targeted therapy in the first-line setting for this patient population, suggesting that resistance to targeted agents may compromise subsequent immunotherapy efficacy. Additionally, SECOMBIT evaluated a sequential "sandwich" approach, incorporating a short course of targeted therapy before transitioning to immunotherapy, which may benefit select patients with high tumor burden or elevated lactate dehydrogenase levels, Ascierto explains. These findings contribute to ongoing discussions on optimizing first-line treatment strategies in 

Paolo A. Ascierto, MD, discusses findings from the SECOMBIT and DREAMseq trials and their implications for first-line treatment selection for patients with BRAF-mutant melanoma.

Dr Ascierto on First-Line Treatment Selection in Advanced BRAF+ Melanoma

Caroline Robert, MD, PhD, head, Dermatology Unit, Gustave Roussy, discusses the role of adjuvant anti–PD-1 therapy in the treatment of patients with resected stage IIB/C melanoma, highlighting findings from the phase 3 KEYNOTE-716 (NCT03553836) and CheckMate 76K (NCT04099251) trials that have informed treatment decisions in this setting.

These trials evaluated the efficacy of adjuvant pembrolizumab (Keytruda) vs placebo and nivolumab (Opdivo) placebo, respectively, in this patient population, and data demonstrated a statistically significant improvement in recurrence-free survival with the immunotherapies. Despite the absence of lymph node metastases, Robert notes that stage IIB/C melanoma carries a recurrence risk comparable with certain stage III cases, warranting investigation into adjuvant immunotherapy. Although Robert notes that the absolute benefit is lower than in more advanced disease, these findings support the integration of PD-1 inhibitors into clinical practice with treatment decisions guided by individualized risk-benefit assessments.

Caroline Robert, MD, PhD, discusses the role of adjuvant anti–PD-1 therapy in resected stage IIB/IIC melanoma based on findings from the KEYNOTE-716 and CheckMate 76K trials.

PER® International Symposium on Melanoma and Other Cutaneous Malignancies | Conference

Dr Ascierto on First-Line Treatment Selection in Advanced BRAF+ Melanoma

Dr Robert on the Role of Adjuvant Anti–PD-1 Therapy in Resected Stage IIB/C Melanoma