Dr. Gajewski on Targets Being Explored in Melanoma

Thomas F. Gajewski, MD, PhD, professor of medicine at The University of Chicago Medicine, discusses what targets are currently being explored in patients with melanoma.

Evidence has shown that a subset of patients already have an ongoing immune response in their tumors, Gajewski explains. Though the immune system is attempting to attack the tumor and get it rejected, it is failing; PD-1 is one of the pathways that keeps the immune response in check, he adds. As this subset is further studied, researchers realize that there are other negative regulators in that same tumor set.

IDO is one of the newer targets being explored that can be targeted with a small molecule inhibitor. Currently, a large phase III trial is randomizing patients with metastatic melanoma to receive anti—PD-1 versus anti–PD-1 plus an IDO inhibitor.

Secondly, there is research being done in patients who have non—T-cell inflamed tumors, he explains. These are tumors that don’t generate any spontaneous immune response to the anti–PD-1 drugs. Multiple strategies are being conducted to ignite immune responses in these tumors, and then render those patients responsive to anti–PD-1 alone or in combination with IDO inhibitors.