Dr. Sullivan on Sequencing Targeted Therapy and Immunotherapy in Melanoma

Ryan Sullivan, MD, medical oncologist, attending physician, Division of Hematology/Oncology, Massachusetts General Hospital, discusses treatment sequencing with targeted therapy and immunotherapy in melanoma.

Typically, patients with advanced melanoma receive immunotherapy in the frontline setting, Sullivan explains. However, with the emergence of BRAF/MEK targeted therapies, the question remains whether targeted therapy or immunotherapy is the optimal frontline regimen, says Sullivan. Whether targeted therapy can replace single-agent PD-1 inhibitors or combination regimens with PD-1 and CTLA-4 inhibitors in this setting is unknown.

As such, treatment decisions should be made on an individualized basis in melanoma, Sullivan explains. Additionally, ongoing efforts are exploring how to optimize second-line treatment for patients who progress in the frontline setting. Few patients will retain long-term disease control with targeted therapy, single-agent immunotherapy, or combination immunotherapy, so additional advances are needed in this space, concludes Sullivan.