Dr. Weber on Discontinuing Immunotherapy in Melanoma

Jeffrey S. Weber, MD, PhD, deputy director and co-director of the Melanoma Program, NYU Langone’s Perlmutter Cancer Center, 2016 Giant of Cancer Care^® in Melanoma, discusses when to discontinue immunotherapy in patients with melanoma.

In early studies involving pembrolizumab (Keytruda), nivolumab (Opdivo), and atezolizumab (Tecentriq), patients were treated until progression, Weber says. In melanoma, 15% to 20% of patients are in remission for 3 to 6 years, so treating them until progression is not rational. Questions of duration now arise, but reasoning for discontinuation is not yet established.

Weber says that in reviewing retrospective data, there are some hints of how long patients with melanoma should be treated. In the KEYNOTE-006 trial, patients were randomized to pembrolizumab versus ipilimumab (Yervoy) in the frontline setting. Data show that patients who received a complete or partial response and went off therapy at 2 years did extremely well, Weber says. The remaining rate of remission in those patients was around 90%. The bottom line, he states, is that it is safe to stop immunotherapy at 2 years in some patients with melanoma. This analysis could potentially be extrapolated to lung, bladder, and head and neck cancer.