Dr. Moon on the Utilization of Relatlimab Plus Nivolumab in Metastatic Melanoma

Helen Heng-Shan Moon, MD, hematologist, oncologist, Kaiser Permanente Riverside Medical Center, discusses the utilization of relatlimab plus nivolumab (Opdualag) in patients with unresectable or metastatic melanoma.

The phase 2/3 RELATIVITY-047 trial (NCT03470922) examined if relatlimab in combination with nivolumab is more effective than nivolumab monotherapy in metastatic melanoma. In March 2022, the FDA approved relatlimab plus nivolumab for the treatment of patients 12 years of age and older with unresectable or metastatic melanoma.

Notably, overall survival was not a primary endpoint of the trial, which is important to keep in mind when evaluating the data, Moon says. One of the questions still surrounding the combination of relatlimab and nivolumab is its efficacy in patients with central nervous system (CNS) metastases, since patients with melanoma are susceptible to CNS metastases, Moon notes. Prior data have shown nivolumab and ipilimumab (Yervoy) have activity in patients with CNS metastases, so further evaluation will be needed to examine how relatlimab and nivolumab perform in that subgroup of patients, Moon adds.

While it is important to have relatlimab and nivolumab as an option for patients, Moon explains she is not ready to say whether relatlimab and nivolumab will replace nivolumab and ipilimumab as the preferred combination for patients with metastatic melanoma.