Dr. Rapisuwon on the Frontline Treatment of Acral and Mucosal Melanoma

Suthee Rapisuwon, MD, medical oncologist, MedStar Health, discusses the frontline treatment of acral and mucosal melanoma.

Immunotherapy is the preferred frontline treatment option for patients with acral and mucosal melanoma since the diseases often lack targetable mutations, says Rapisuwon. Data from the phase 3 CheckMate-067 trial demonstrated activity with ipilimumab (Yervoy) in combination with nivolumab (Opdivo) for patients with acral and mucosal melanoma. Although the efficacy was generally decreased in these subtypes compared with that in cutaneous melanoma, this is the preferred frontline regimen, Rapisuwon explains.

Future research efforts are aiming to identify novel combinations to treat these patient populations, Rapisuwon says. For example, Chinese investigators are looking into combining PD-1 inhibitors with VEGF inhibitors, such as axitinib (Inlyta). The goal of combination therapy is to provide patients with additional benefit compared with PD-1 inhibitors alone, Rapisuwon explains. However, more data are needed to establish the utility of combination therapy and move forward with other clinical trials, concludes Rapisuwon.