BRAF inhibitor cessation prior to disease progression in metastatic melanoma: Long-term outcomes

BRAF mutant melanoma treated with BRAF ± MEK inhibitor (targeted therapy) has a high response rate; however, most patients progress (PD). Some patients have durable response, but it is unknown whether treatment can be discontinued in these patients. We describe the recurrence risk, progression patterns, response to subsequent treatment, and survival of patients with advanced melanoma who ceased targeted therapy prior to PD … Continua a leggere

Tumor-Infiltrating Lymphocyte Therapy or Ipilimumab in Advanced Melanoma

Immune checkpoint inhibitors and targeted therapies have dramatically improved outcomes in patients with advanced melanoma, but approximately half these patients will not have a durable benefit. Phase 1-2 trials of adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) have shown promising responses, but data from phase 3 trials are lacking to determine the role of TILs in treating advanced melanoma … Continua a leggere

How I treat brain metastases of melanoma

Brain metastases are common in advanced melanoma and cause death in >50% of patients. Until recently, median survival was only ∼4 months. Improved systemic treatment including immune checkpoint inhibitors and combinations of BRAF/MEK inhibitors, however, has significantly improved intracranial tumor response and survival. In addition, advances in radiation therapy have also improved the intracranial outcomes for advanced melanoma patients … Continua a leggere

Risk of Overusing Sentinel Node Biopsy in Patients With Thin Melanoma

Moncrieff et al recently reported on results of sentinel node (SN) biopsy in a retrospective study of 3,607 patients with pT1b or pT2a melanoma, who underwent SN biopsy between 2005 and 2020 at nine cancer centers while also assessing the prognostic value of tumor deposit maximum dimension in patients with SN micrometastases. SN biopsy was positive in 408 patients (11.3%). These patients would be classified with stage IIIA disease according to the eighth edition …  Continua a leggere

IL7 genetic variation and toxicity to immune checkpoint blockade in patients with melanoma

Treatment with immune checkpoint blockade (ICB) frequently triggers immune-related adverse events (irAEs), causing considerable morbidity. In 214 patients receiving ICB for melanoma, we observed increased severe irAE risk in minor allele carriers of rs16906115, intronic to IL7. We found that rs16906115 forms a B cell-specific expression quantitative trait locus (eQTL) to IL7 in patients … Continua a leggere