Single agent vs combination immunotherapy in advanced melanoma: a review of the evidence

被引:6
作者
Benhima, Nada [1 ,2 ]
Belbaraka, Rhizlane [1 ]
Fonts, Mireille D. Langouo [2 ]
机构
[1] Mohammed VI Univ Hosp, Dept Med Oncol, Marrakech, Morocco
[2] Jules Bordet Inst, Med Oncol Clin, Brussels, Belgium
关键词
advanced melanoma; anti-LAG3; anti-PD-1; combination; immunotherapy; METASTATIC MELANOMA; OPEN-LABEL; IPILIMUMAB; SURVIVAL; MULTICENTER; NIVOLUMAB; VEMURAFENIB; DABRAFENIB; MUTATIONS;
D O I
10.1097/CCO.0000000000001014
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of review The aim of this review is to outline the current landscape of advanced melanoma treatment options, provide insights on selecting combination therapies within different clinical scenarios, capture clinical relevance of anti-programmed cell death protein 1 (PD-1) monotherapy, and explore the unmet needs with immune check-point inhibitors (ICI) in advanced melanoma. Recent findings ICI based treatment consisted of single agent ICI or dual combination ICI-ICI is the standard of care of front-line treatment of metastatic or unresectable melanoma. PD-1 inhibitors (Pembrolizumab and Nivolumab) improved progression free survival (PFS) and overall survival (OS) compared to chemotherapy and cytotoxic T-lymphocyte associated protein 4 (CTLA-4) inhibitors (Ipilimumab and Tremelimumab). The dual ICI combination (Nivolumab and Ipilimumab) provided profound and durable responses better than monotherapy, and the longest overall survival ever achieved in advanced disease, including in patients with murine sarcoma viral oncogene homolog B (BRAF)-mutated disease, but at the cost of a high risk of severe toxicity. The new dual blockage of LAG-3 and PD-1 (Nivolumab-Relatlimab) emerges as a valid option with promising efficacy outcomes and a favourable toxicity profile. Mature survival data is still needed to capture the real benefit. Summary These new plethora of options pose new challenges not only for optimal treatment sequencing strategies but especially for management of adverse effects, endorsing the need to integrate a holistic and personalized approach for patient care.
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收藏
页码:69 / 73
页数:5
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