Experts Highlight Advances in Melanoma Detection, Prevention, and Treatment

Melanoma, a deadly form of skin cancer, affects over 100,000 Americans each year. Experts are stressing the significance of early detection and prevention through UV protection, while also underscoring noteworthy progress in treatment options for patients with late-stage cases.

Dr. Charles Dunn from Advanced Dermatology and Cosmetic Surgery emphasizes that anyone can develop skin cancer, regardless of age, size, ethnicity, or skin color. He highlights the necessity for routine skin checks with a dermatologist, as early detection can lead to a survival rate of over 99%, compared to a much lower rate if caught late or if the cancer spreads. To promote awareness, several Advanced Dermatology locations will offer free skin checks as part of Melanoma Monday on May 6, 2024.

While prevention and early detection are essential, experts also discuss the advancements being made in immunotherapies, experimental vaccines, and clinical trials for advanced melanoma cases. The FDA recently approved lifileucel, a tumor-infiltrating lymphocyte (TIL) therapy, for the treatment of patients with unresectable or metastatic melanoma who were previously treated with a PD-1 inhibitor and a BRAF inhibitor with or without a MEK inhibitor.

The pivotal phase 2 C-144-01 trial demonstrated a 31.5% objective response rate and durable responses in patients who had received a mean of 3.3 prior lines of therapy. Lifileucel was also effective in the mucosal melanoma cohort, where the objective response rate was 50%. These findings suggest that lifileucel may address historical unmet needs in relapsed melanoma.

Why this matters: The approval of lifileucel offers a new therapeutic option for patients with metastatic melanoma who have experienced treatment failure with first-line therapy. TIL therapy involves harvesting and expanding a patient's own tumor-infiltrating T cells, which can mount a potent anti-tumor immune response when infused back into the patient.

Experts also discussed a pooled analysis that found increased response rates with dual checkpoint inhibition using ipilimumab and nivolumab compared to anti-PD1 monotherapy in patients with high-risk resectable melanoma. However, the combination therapy was associated with more grade 3 or 4 immune-related adverse effects. An alternative dosing regimen of 1 mg/kg ipilimumab and 3 mg/kg nivolumab was found to have a better adverse effect profile than the conventional dosing, with no significant efficacy differences.

Ongoing research is focused on combining TIL therapy with anti-PD-1 therapy, as well as exploring earlier use of TIL therapy in the treatment paradigm for advanced melanoma. Experts emphasize that the ideal candidate for TIL therapy is a patient in the second line or beyond, with good cardiac and pulmonary function, and no contraindications.

Key Takeaways

• Melanoma affects over 100,000 Americans yearly; early detection is crucial.
• Free skin checks offered on Melanoma Monday to promote early detection.
• FDA approved lifileucel, a TIL therapy, for unresectable/metastatic melanoma.
• Dual checkpoint inhibition increases response rates but has more adverse effects.
• Ongoing research focuses on combining TIL therapy with anti-PD-1 therapy.