Join Jason Rockhill, MD and John Thompson, MD as they present their multidisciplinary expertise on a range of cases pertaining to advanced disease melanoma.

Treatment of advanced melanoma has entered a new era with the approval of novel immunotherapeutic and targeted agents. Two additional targeted agents—MEK inhibitor trametinib and BRAF inhibitor dabrafenib—have received approval for patients with documented V600 mutation of BRAF based on survival benefits in randomized trials. A new class of upcoming agents targeted against the programmed death -1 (PD-1) receptor (lambrolizumab and nivolumab) also demonstrated durable responses in patients with advanced melanoma, which may further change the landscape of this rapidly evolving field.

Evidence from follow-up studies of vemurafenib and ipilimumab shed light on their use in different clinical settings, drug resistance mechanisms, and side effects management. Research also focused on the sequence and combination of novel drugs. A recent FDA approval was granted to the combination of dabrafenib and trametinib based on improved progression-free survival compared to monotherapy.

In advanced disease, clinicians need to know the prognostic markers prior to deciding on a treatment for the patient. With the advent of targeted therapy, mutation testing has become a critical component in the routine work-up of advanced disease.  Management of adverse events and response to therapy may be different than with traditional chemotherapy. These differences should be discussed with patients prior to beginning therapy with immune-oncology agents.