Looking Ahead: What’s on the Horizon in Advanced Melanoma
Panelists discuss how emerging advances in melanoma treatment include next-generation tumor-infiltrating lymphocyte therapy, oncolytic immunotherapy, bispecific antibodies, cancer vaccines, and neoadjuvant approaches that may allow de-escalation of both surgery and systemic therapy while improving treatment-free survival.
Future Directions in Melanoma Treatment
Key Discussion Points:
- Emerging therapies and treatment approaches in melanoma
- Role of biomarkers in treatment selection
- Neoadjuvant and de-escalation strategies
Key Points for Physicians:
- Promising emerging therapies include next-generation tumor-infiltrating lymphocytes (TIL) therapy, oncolytic immunotherapy (RP-1 with PDUFA date of July 22), bispecific antibodies, and cancer vaccines (Moderna melanoma vaccine)
- Practice-changing neoadjuvant data includes S1801 with pembrolizumab, NADINA with ipilimumab/nivolumab, showing potential for de-escalation of both systemic therapy and surgery
- Critical need for predictive biomarkers for both efficacy and toxicity, particularly for adjuvant therapy where many patients may be overtreated
Notable Insights:
Neoadjuvant immunotherapy approaches have demonstrated significant promise, with potential for de-escalation of both surgical extent and total systemic therapy duration—patients achieving pathological complete response after neoadjuvant therapy may require only 6 weeks of treatment.
Clinical Significance:
The melanoma treatment landscape continues to evolve rapidly with multiple promising therapeutic approaches in development, though predictive biomarkers remain a critical unmet need to optimize patient selection and treatment sequencing.
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