Dr. Sznol on the Use of Immunotherapy in Melanoma

Mario Sznol, MD, professor of medicine, co-director, Yale SPORE in Skin Cancer, Yale Cancer Center, discusses the use of immunotherapy in melanoma.

There are 2 major immunotherapeutic options in melanoma, says Sznol. Talimogene laherparepvec (T-VEC; Imlygic) could be considered a third option. However, T-VEC is rarely used in the clinic, says Sznol. The 2 most important drug classes are anti–PD-1 agents, such as nivolumab (Opdivo) and pembrolizumab (Keytruda), and anti–CTLA-4 agents, such as ipilimumab (Yervoy). Single-agent anti–PD-1 therapy can lead to long-term survival rates in the range of 40% to 45%, says Sznol. The addition of an anti–CLTA-4 agent could add another 7% to 10% to that 5-year survival rate.

Anti–PD-1 agents are commonly used alone or in combination with an anti–CTLA-4 agent in the frontline setting in patients with metastatic melanoma, concludes Sznol.