MPNE at ASCO 2015- Bettina will blog about all things Melanoma!
Abstract of high interest although not a big surprise anymore: ipilimumab+ nivolumab almost doubled progression free survival in comparison with ipilimumab alone: 8,9 vs 4,7 months Overall response rate was 60% for combi vs 11% for IPI alone. No complet response was observed in the IPI arm. Also better responses rates on combi - for the patients with poor prognostic factors. http://abstracts.asco.org/156/AbstView_156_144615.html
http://abstracts.asco.org/156/AbstView_156_148865.html Here, data from a very small cohort- encouraging use of pembrolizumab for patients with metastatic uveal melanoma. One patient had complete response, one - partial response and one-stable disease. PFS was 12.2 weeks and two patients are still receiving therapy.
http://abstracts.asco.org/156/AbstView_156_152690.html - ...and here is a study (8 cases) on the etiology of uveal melanoma showing that distinctive agents might cause the disease.
Dabrafenib +Trametinib vs Dabrafenib (CombiD) - data from live asco presentation today via Bettina - 29% reduction in risk of death combo over monoteraphy25.1 vs 18.7 months PFS in favour of the combo2-year OS- > 50% on combinationno data in the abstract http://abstracts.asco.org/156/AbstView_156_149861.html
Clinical characteristics correlated with higher response to pembrolizumabhttp://abstracts.asco.org/156/AbstView_156_145183.html-the data are from a phase I trial - 110 patients and ORR = 40%Higher ORR reported when: - LDH ≤ normal (ORR 52.2%), - no previous ipilimumab (ORR 48.3%),- presence of lung metastasis (ORR 52.8%).Patients with liver metastasis had worse response (ORR 18.4%), as did those with liver and lung metastases (ORR 31.3%)
ASCO 2015: Complete Lymph Node Dissection Does Not Improve Survival in Patients With Melanoma and Micrometastases - the median follow-up of 35 months shows no significant differences in 3-year and 5-year recurrence-free survival and melanoma-specific survival. http://www.ascopost.com/ViewNews.aspx?nid=28616&utm_medium=Email&utm_source=ExactTarget&utm_campaign=&utm_term=4210292
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Linked to this article Modelling vemurafenib resistance in melanoma reveals a strategy to forestall drug resistance http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930354/, a presentation of Dummer ''he recommends cycling through targeted therapies: immunotherapies and then going back on targeted -a more holistic approach.
Related to an ASCO presentation - Efficacy of MEK Inhibition in Uveal Melanoma http://jama.jamanetwork.com/article.aspx?articleid=1881312on the drug selumetinib vs chemotheraphy in uveal melanoma:- median survival 9.1 months on chemotherapy vs 11.8 months selumetinib- PFS - 7 weeks chemo vs 15.9 weeks selumetinib- OS - no improvement- selumetinib is giving fast responses, good PFS but not improvement in OS.( it can be good as a ''bridge'')
TAPUR- a Non Randomized Clinical Trial collecting real-world data in various cancers http://www.ascopost.com/ViewNews.aspx?nid=28617&utm_medium=Email&utm_source=ExactTarget&utm_campaign=&utm_term=4210292
Neoadjuvant BRAF (dabrafenib) and MEK (trametinib) http://abstracts.asco.org/156/AbstView_156_152525.html
Adjuvant anti-PD-1 clinical trials- http://abstracts.asco.org/156/AbstView_156_151015.htmlImmune markers suporting the use of anti-PD1 as adjuvant theraphy
Circulating melanoma cells (CMC) is linked with high risk recurrence in stage III melanoma patients - http://meetinglibrary.asco.org/content/152274-156
BRAFi ENCO (LGX818) and MEKi BINI (MEK162) -- each shown promising single-agent activity in BRAFV600–mutant melanoma 78 and 72% respectively confirmed RR in phase Ib/II. - http://abstracts.asco.org/156/AbstView_156_146432.htmlRelated -- a Ph III trial Columbus with these agents (US and Europe) https://clinicaltrials.gov/ct2/show/study/NCT01543698#contacts
IPILIMUMAB and T-VEC (oncolytic virus) http://abstracts.asco.org/156/AbstView_156_151884.html- Overall Response Rate -56% - Complete Responses -33%- Durable Response Rate -44%. - Median progression-free survival (PFS) -10.6 months - Median overall survival (OS) - not reached; - 12-month and 18-month survival- 72.2% and 67%. - 50% of uninjected lesions respondedPhase 2 (ipi vs T-VEC+ipi) is ongoing