Dr. Johnson on Promise of Combination Therapy in Melanoma

Douglas B. Johnson, MD, assistant professor of medicine, Vanderbilt University Medical Center, clinical director, Melanoma Research Program, Vanderbilt-Ingram Cancer Center, discusses the promise of combination therapy in patients with melanoma.

This biggest advancement in this treatment paradigm over the last several years has been the advent of combination therapies, Johnson says. This includes ipilimumab (Yervoy) plus nivolumab (Opdivo) in terms of immunotherapy combinations, as well as the various BRAF and MEK inhibitor combinations. The rise of these strategies has increased response rates and the proportion of patients who benefit. For example, the combination of anti—PD-1 and anti–CTLA-4 therapy has demonstrated response rates of about 60% compared with 40% with single-agent ipilimumab. In patients with BRAF-mutant melanoma, the combination of BRAF and MEK inhibition has resulted in impressive response rates of about 70%.

Moving forward, it is going to be a challenge for researchers to expand this benefit even further. Ongoing studies are looking at combining anti—PD-1 therapy with other novel immune agents, targeted therapies, and oncolytic viral therapies. Researchers are hopeful that these strategies under investigation will translate to clinical benefit, Johnson says.