Dr. Wolchok on Progress After Anti-PD-1 Monotherapy in Melanoma

Jedd D. Wolchok, MD, PhD, chief, Melanoma and Immunotherapeutics Service, Department of Medicine and Ludwig Center at Memorial Sloan Kettering Cancer Center, 2014 Giant of Cancer Care in Melanoma, discusses an ongoing clinical trial that will explore optimal treatments for patients with melanoma who fail on a PD-1 inhibitor as a single agent.

How to treat patients who relapse on PD-1 monotherapy is a challenging question, Wolchok explains. Therefore, a clinical trial will randomize patients with metastatic melanoma who have progressed on this treatment to ipilimumab (Yervoy) or ipilimumab plus nivolumab (Opdivo; NCT02731729). There is a vast difference in the toxicity profile between both options, Wolchok explains.

The dosing regimens to be studied will be 3 mg/kg of ipilimumab and 1 mg/kg of nivolumab, which is the dosing schedule used in the CheckMate-067 trial, and a flipped dose of 3 mg/kg of nivolumab and 1 mg/kg of ipilimumab to try to improve the safety to efficacy profile. This is a regimen that has been explored in renal cell carcinoma, urothelial cancer, and non—small cell lung cancer.

Wolchok says he is still very comfortable with administering the combination of 3 mg/kg of iplilimumab and 1 mg/kg of nivolumab to patients until further research demonstrates different findings.