Dr. Weber on Duration of Checkpoint Inhibitor Therapy 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 duration of checkpoint inhibitor therapy in patients with melanoma.

In light of the success of checkpoint inhibitor therapy in patients with melanoma, investigators are now questioning duration of treatment, as well as treatment discontinuation. In small retrospective trials of patients with melanoma who received pembrolizumab (Keytruda) or nivolumab (Opdivo), those who were metabolically or histologically negative and stopped at 1 year did very well, even if they did not have a complete response by CT scan. These patients had an over 90% chance of remaining in remission, as well.

Weber says that these findings give him confidence in treating patients with melanoma for at least 1 year, and no more than 2 years with checkpoint inhibitor therapy. At 1 year, if a patient has a stable response over 2 scans, Weber says that he would tell them to get a PET CT scan. If there is complete metabolic regression on the PET scan, no matter what is seen anatomically on the CT, Weber says he would either discontinue treatment or give 1 more cycle and then stop. Those patients can then safely be observed. If needed, a single-agent PD-1 inhibitor can be re-introduced.