James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK, discusses the highlights in melanoma from the 2016 Annual Meeting of the American Society of Oncology (ASCO), held in Chicago, IL.
First, Dr Larkin highlights that data for the treatment of uveal melanoma with immunotherapy and in particular the newer immune checkpoint inhibitors, is now available. The data has shown that the drugs do not work as well in cases of uveal melanoma as they do in skin melanoma and cases of mucosal melanoma. Results show that patients with uveal melanoma who are treated with these drug do not see any large benefit. He thus believes that this highlights the need to continue carrying out trials to understand more about the biology of the disease, and thus introduce rational treatment strategies.
Dr Larkin proceeds to highlight the development of a new MEK inhibitor named binimetinib compared with dacarbazine, a Phase III trial (NCT01763164) in NRAS-mutant melanoma (which accounts for about 20% of melanomas). Results of the trial were positive; in terms of progression-free survival (PFS), binimetinib was better than dacarbazine. He also discusses the side effects, which include rash and hypertension. He suggests that binimetinib may become a treatment option for these patients; however, it is still debatable whether the level of benefit with binimetinib will be as great as the levels of benefit we have seen with BRAF inhibitors in BRAF-mutant melanoma, for example.
Lastly, he explains that we have more follow-up data from some of the earlier checkpoint inhibitor clinical trials such as pembrolizumab. According to Dr Larkin, there seems to be a group of patients who are getting durable benefit from the treatment over 2-3 years. Data seen regarding dabrafenib and trametinib again highlights that there is subset of patients who are seeing prolonged benefit from treatment. However, he emphasizes that further developments and advances need to be made and further, that it is important to keep giving patients the chance to enter clinical trials. Recorded at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL.