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| LETTER TO EDITOR |
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| Year : 2022 | Volume
: 5
| Issue : 1 | Page : 196-197 |
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Relatlimab and nivolumab in untreated advanced melanoma
Shuvadeep Ganguly, Ajay Gogia
Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| Date of Submission | 04-Feb-2022 |
| Date of Decision | 26-Feb-2022 |
| Date of Acceptance | 01-Mar-2022 |
| Date of Web Publication | 31-Mar-2022 |
Correspondence Address:
Ajay Gogia
Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/crst.crst_71_22
How to cite this article:
Ganguly S, Gogia A. Relatlimab and nivolumab in untreated advanced melanoma. Cancer Res Stat Treat 2022;5:196-7 |
Tawbi et al.[1] recently reported improvement in progression-free survival (PFS) with the relatlimab–nivolumab combination over nivolumab monotherapy in previously untreated, unresectable/metastatic melanoma. The nivolumab–ipilimumab combination has improved the response rate in advanced melanoma with a significant increase in grade 3/4 adverse events (55%),[2] making its real-world application difficult. Hence, the incidence of grade 3/4 adverse events with the relatlimab–nivolumab combination (18.9%) appears encouraging. Nevertheless, 30.4% (108/355) patients discontinued the combination treatment due to reasons other than disease progression. Hence, predictive models or biomarkers for appropriate patient selection are crucial to explore.
For BRAF-mutant melanoma, combination therapy with BRAF/MEK inhibitors is an acceptable first-line strategy.[3] Among 38.5% (275/714) patients positive for BRAF mutations, subsequent systemic therapy with BRAF/MEK inhibitors could be started in only 19.3% (91/470) after discontinuing study treatment. Combination of programmed cell death protein 1 blockade with BRAF/MEK inhibition has also been explored in advanced melanoma with improved survival outcome.[4] With preclinical evidence suggesting proimmunogenic effect of MEK inhibition,[5] it is important to investigate the combination of LAG3 blockade with BRAF/MEK inhibition in advanced BRAF-mutant melanoma.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Tawbi HA, Schadendorf D, Lipson EJ, Ascierto PA, Matamala L, Castillo Gutiérrez E, et al. Relatlimab and Nivolumab versus Nivolumab in Untreated Advanced Melanoma. N Engl J Med 2022;386:24-34.  |
| 2. | Larkin J, Chiarion-Sileni V, Gonzalez R, Grob JJ, Cowey CL, Lao CD, et al. Combined nivolumab and ipilimumab or monotherapy in untreated melanoma. N Engl J Med 2015;373:23-34. |
| 3. | Mittal A, Gupta A, Rastogi S. Melanoma at American Society of Clinical Oncology 2020-An update and its implications in the Indian setting. Cancer Res Stat Treat 2020;3:594-7. [Full text] |
| 4. | Liu Y, Zhang X, Wang G, Cui X. Triple combination therapy with PD-1/PD-L1, BRAF, and MEK inhibitor for stage III–IV melanoma: A systematic review and meta-analysis. Front Oncol 2021;11:693655. |
| 5. | Baumann D, Hägele T, Mochayedi J, Drebant J, Vent C, Blobner S, et al. Proimmunogenic impact of MEK inhibition synergizes with agonist anti-CD40 immunostimulatory antibodies in tumor therapy. Nat Commun 2020;11:2176. |
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