Dr. Ascierto on Choosing Combinations in Treatment of Melanoma

Paolo A. Ascierto, MD, director of the Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy at the National Tumor Institute Fondazione G. Pascale in Naples, discusses how to choose between available combination therapies in the treatment of patients with melanoma.

There are 3 combinations of BRAF and MEK inhibitors that have shown efficacy and tolerability in the treatment of patients with melanoma. The main factor in distinguishing between the 3 regimens and guiding treatment decisions will be in their safety profiles, Ascierto says. For example, the combination of binimetinib (Mektovi) and encorafenib (Braftovi) has a strong safety profile, Ascierto notes, so for patients with pre-existing comorbidities, this may be the right option. In general, this emerging combination is good news for the treatment landscape because it provides a novel and safe option for patients.

Ascierto adds that there are ongoing trials looking at the proper sequencing of these combinations. Nivolumab (Opdivo) and ipilimumab (Yervoy) have also shown encouraging activity in these patients, so where immunotherapy fits in is something that also needs to be considered.