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Contents in the Video:
00:00
Prof. Dummer reports on his trial on neoadjuvant melanoma therapy using an intralesional injection of T-Vec, with encouraging improvements in relapse-free survival.
03:24
A small trial showed that in cutaneous squamous cell carcinoma, neoadjuvant therapy with an anti-PD1 antibody generated high pathological complete remission rates.
04:10
In the adjuvant setting, the small, 3-armed, placebo-controlled IMUNED trial with patients in stage IV melanoma with no evidence of disease showed that the combination ipilimumab/nivolumab is strikingly superior to nivolumab monotherapy.
06:15
How fast can immunotherapy work? Prof. Michiel and Prof. Dummer summarize the evidence for a minimum duration of treatment in the adjuvant setting.
08:15
TMB, IFNG and T cell presence: What is the best marker for predicting an antitumor immune response to conclude adjuvant therapy?
09:29
The 3-year-follow-up of the CheckMate 238 trial showed reassuring results in the adjuvant setting implicating that nivolumab had superior activity compared to ipilimumab 10 mg/kg, which is relevant for preventing toxicity.
11:15
Guideline session for melanoma adjuvant treatment: It is now clear that patients in melanoma have to be considered for adjuvant treatment, backed by clear results of relapse-free survival, which our discussants are convinced will translate into overall survival. The drawbacks and side effects need to be discussed, but the risk/benefit ratio is in favor of adjuvant therapy.
13:32
5-year-update of the Checkmate 067 trial: In the unresectable stage IV setting, 53% of patients treated with ipilimumab and nivolumab are alive, most are free from disease, which is a sign for a “functional cure”, making the combination the gold standard at this time. For the future, biomarkers of toxicity are warranted to select patients for IO combination therapy.
17:19
Prof Dummer’s and Prof. Michielin’s approaches for discontinuing adjuvant immunotherapy in patients with a complete remission: finding the balance between maintaining a complete remission and preserving resources and preventing a higher risk of serious immune-related side effects.
20:22
Patients with brain metastases: Update on the ABC trial looking at symptomatic patients shows maturing results with a higher plateau in relapse free survival for the combination compared to nivolumab monotherapy and changes clinical practice in this challenging patient population.
22:30
Prof. Michielin’s and Prof. Dummer’s conclusion and outlook for the field, and one negative trial that showed non-superiority of a MEK inhibitor in combination with atezolizumab compared to pembrolizumab monotherapy.
Interview with:
Prof. Dr. Reinhard DummerProf. Dr. Olivier Michielin
Interview by:
Mag. Anna Egger
Produced by:
Mag. Oliver Eberhardt
Mag. Anna Egger
Mag. Anna Egger
30 Sept 2019Scientific knowledge exchange

ESMO 2019: New insights in melanoma treatment

Prof. Reinhard Dummer, MD, University Hospital Zurich, and Prof. Olivier Michielin, MD, PhD, CHUV Lausanne, discuss the current advances and challenges in melanoma treatment with a focus on immunotherapy.

This year’s highlights were new neoadjuvant options, refinement of adjuvant therapy, and a smarter use of immunotherapy to achieve cost-efficiency and prevent side-effects.

Abstracts discussed in the interview:

  • Dummer R et al. Primary 2-year (yr) results of a phase II, multicenter, randomized, openlabel trial of efficacy and safety for talimogene laherparepvec (T-VEC) neoadjuvant (neo) treatment (tx) plus surgery (surg) vs surg in patients (pts) with resectable stage IIIB-IVM1a melanoma. #LBA66
  • Schadendorf D et al. Adjuvant immunotherapy with nivolumab (NIVO) alone or in combination with ipilimumab (IPI) versus placebo in stage IV melanoma patients with no evidence of disease (NED): A randomized, double-blind phase II trial (IMMUNED). #LBA67
  • Weber J et al. Adjuvant nivolumab (NIVO) versus ipilimumab (IPI) in resected stage III/IV melanoma: 3-year efficacy and biomarker results from the phase III CheckMate 238 trial. #1310O
  • Lee R et al. ESMO Clinical Practice Guidelines 2: Localised melanoma resected: Adjuvant therapy followed by systemic relapse
  • Long G et al. Long-term outcomes from the randomized phase II study of nivolumab (nivo) or nivo+ipilimumab (ipi) in patients (pts) with melanoma brain metastases (mets): Anti-PD1 brain collaboration (ABC). #1311O
  • Arance A et al. Combination treatment with cobimetinib (C) and atezolizumab (A) vs pembrolizumab (P) in previously untreated patients (pts) with BRAFV600 wild type (wt) advanced melanoma: Primary analysis from the phase III IMspire170 trial. #LBA69

ESMO Congress 2019

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ESMO 2019: A long-term chance for patients with metastatic melanoma