Developments in Melanoma Research & A Look At What’s Ahead

Meredith McKean , MD, MPH, Director, Melanoma & Skin Cancer Research; Executive Chair, Melanoma Research Executive Committee, SCRI, discusses exciting advances in the field of melanoma research and the critical importance of clinical trials to advance therapies for people facing this cancer.

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Advances in Research & Treatment

According to Dr. McKean, research has advanced over the past several years in both early- and late-stage melanoma. “Immune checkpoint inhibitors that were previously approved in the metastatic setting and stage 3 setting have now been advanced to the stage II setting,” says Dr. McKean. “This is a significant development because patients with stage IIB/C melanoma are at high risk for recurrence, and there are now treatment options that are available to them.”

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Additionally, molecular profiling can help indicate patients who may be at higher risk of recurrence, despite having an early-stage disease. Gene expression profiling has become a helpful tool, in addition to the historical prognostic markers of tumor depth and ulceration, to determine stage I/II patients who may be at a higher risk of recurrence.

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Personalized therapies continue to be a key area of research, and currently there are clinical trials that explore genetic drivers outside of BRAF V600 metastatic melanoma, including atypical BRAF mutations, NRAS mutations, CDKN2A/B loss and MTAP loss. “These are exciting options, particularly for patients who are immunosuppressed or have autoimmune conditions and are not able to receive the standard immune therapy options that other patients can,” says Dr. McKean. “This is a patient population looking for treatment options because there is nothing available or there are significant challenges to receiving treatment.”

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In the metastatic setting, one of the most exciting recent advances was the U.S. Food & Drug Administration’s approval of tumor-infiltrating lymphocytes (TIL), an immunotherapy that will soon be offered closer to home for many patients with metastatic melanoma. SCRI participated in this research.

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The Future of Research & Importance of Clinical Trials

In the study CheckMate 067 that studied ipilimumab, a CTLA-4 inhibitor, versus nivolumab, an anti PD-1 inhibitor, and ipilimumab, the 6.5 year follow up showed that almost 50% of patients were still alive, but unfortunately 50% of patients were not. “At SCRI, we continue to work on opening and enrolling to clinical trials that look at new opportunities for these patients who may not respond to these front-line therapies and have challenging treatment options and an overall poor prognosis,” says Dr. McKean. “Many of the patients I see were told they did not have options elsewhere, and they look to the SCRI network for opportunities to access new therapies.”

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