A roundtable discussion with Drs Jason J Luke, Michael A Postow
and Ryan J Sullivan on recent developments in the treatment of
melanoma, including these topics:
Case (Dr Sullivan): A woman in her late teens
presents with a nodule on her chin and is diagnosed with Stage IIIA
melanoma (00:00)
Association between the use of tanning beds and risk of
melanoma (02:38)
Clinical care of patients with Stage IIIA melanoma (05:21)
Risk of recurrence for patients with Stage III melanoma
(08:16)
Perspective on the benefits and risks of adjuvant therapy for
patients with melanoma (09:57)
Case (Dr Luke): A man in his early 50s with
locally advanced melanoma with a BRAF V600E tumor mutation receives
adjuvant dabrafenib and trametinib (15:57)
BRAF tumor mutation testing for patients with melanoma
(16:56)
Therapeutic options in the adjuvant setting for patients with
melanoma (18:47)
Efficacy and tolerability of immunotherapy in the adjuvant
setting (21:51)
Choice of dabrafenib/trametinib versus immune checkpoint
inhibition as adjuvant therapy for melanoma with BRAF mutation
(24:50)
Tolerability of and quality of life with BRAF/MEK inhibitor
combinations versus immunotherapy (26:48)
Monitoring and management of side effects associated with
BRAF/MEK inhibitors (30:59)
Counseling patients who are receiving BRAF/MEK inhibitors about
sun exposure (33:28)
Selection of anti-PD-1 antibody therapy for patients with
locally advanced melanoma (36:16)
Role of vemurafenib in the adjuvant setting (37:26)
Case (Dr Postow): A woman in her early 30s
with Stage III melanoma with a BRAF V600E tumor mutation receives
adjuvant dabrafenib and trametinib (40:33)
Reduction in the risk of recurrence with adjuvant therapy for
patients with Stage III melanoma (43:29)
Recurrence-free survival benefit with adjuvant nivolumab, alone
or in combination with ipilimumab, compared to placebo for patients
with Stage IV melanoma and no evidence of disease in the Phase II
IMMUNED study (45:26)
Tumor mutation burden and other potential biomarkers of
response to targeted therapy or immune checkpoint inhibition in the
adjuvant setting (50:43)
Optimal duration of adjuvant therapy with dabrafenib/trametinib
and immune checkpoint inhibitor therapy (54:19)
Ongoing investigation of neoadjuvant therapy for locally
advanced melanoma (58:01)
Effect of BRAF/MEK inhibitors on the tumor microenvironment
(1:03:28)
Challenges with identifying immune-related adverse events
(1:06:06)
Management of immune-related adverse events in patients
receiving immune checkpoint inhibitor therapy (1:07:57)
Neurologic toxicities associated with the use of immune
checkpoint inhibitors (1:10:42)
Multidisciplinary team approach in the management of
immune-related adverse events (1:12:45)
Educating patients and emergency room personnel about
immunotherapy and the potential for immune-related adverse events
(1:15:59)
Response to immune checkpoint inhibition in noninvasive solid
tumors (1:18:34)
Incidence and management of nonmelanoma skin cancer
(1:20:26)
Perspective on the utility of immune checkpoint inhibitors for
patients with melanoma who have undergone transplants
(1:24:10)
Risks and benefits of immunotherapy for patients with
metastatic melanoma who have received solid-organ transplants
(1:26:30)
Monitoring and care of patients with melanoma and preexisting
autoimmune disease receiving immune checkpoint inhibitors
(1:28:33)
Case (Dr Sullivan): A man in his late 50s with
Stage IIIC, BRAF wild-type melanoma on his arm experiences
intermittent tingling of his mouth during treatment with adjuvant
nivolumab (1:33:36)
Cranial neuropathy associated with immune checkpoint blockade
(1:36:15)
Counseling patients about the benefits and risks of immune
checkpoint inhibitors in the adjuvant setting (1:38:35)
Correlation between toxicity and benefit with immune checkpoint
inhibitors (1:42:24)
Selection among the BRAF/MEK inhibitor combinations
dabrafenib/trametinib, vemurafenib/cobimetinib and
encorafenib/binimetinib for patients with metastatic melanoma with
BRAF tumor mutations (1:45:46)
Advantages of the encorafenib/binimetinib combination for
patients with melanoma with BRAF tumor mutations (1:46:42)
Use of encorafenib/binimetinib versus dabrafenib/trametinib
versus vemurafenib/cobimetinib in clinical practice (1:47:34)
COLUMBUS: Results of a Phase III trial comparing
encorafenib/binimetinib, vemurafenib and encorafenib for patients
with melanoma with BRAF tumor mutations (1:49:08)
Case (Dr Luke): A man in his mid-50s with
metastatic melanoma with a BRAF V600E tumor mutation experiences a
complete resolution of CNS lesions after receiving ipilimumab with
nivolumab (1:50:38)
Therapeutic approach for patients with melanoma who develop
brain metastases (1:52:07)
Locoregional versus systemic therapy for patients with brain
metastases (1:56:27)
Activity and tolerability of nivolumab/ipilimumab in patients
with CNS metastases (1:58:58)
Management of colitis associated with immune checkpoint
inhibitors (2:00:30)
Efficacy of radiation therapy for brain metastases in melanoma
(2:03:15)
Optimal type of radiation therapy for patients with CNS
metastases (2:05:39)
Radiation necrosis with the combination of stereotactic
radiation and immune checkpoint blockade (2:08:02)
Case (Dr Postow): A man in his late 60s with
low-volume metastatic mucosal melanoma and 1 incidental brain
metastasis receives nivolumab/ipilimumab (2:09:39)
Response to nivolumab/ipilimumab in patients with brain
metastases (2:11:33)
Side effects with nivolumab/ipilimumab (2:13:50)
Management of hyperthyroidism associated with immunotherapy
(2:15:42)
Monitoring for endocrinopathy in patients receiving immune
checkpoint inhibitors (2:19:03)
BRAF tumor mutation status and benefit from
nivolumab/ipilimumab (2:21:00)
Correlation of PD-L1 expression and benefit from immune
checkpoint blockade in patients with BRAF wild-type melanoma
(2:23:47)
Role of tumor mutation burden and PD-L1 expression as
predictive markers of benefit with immune checkpoint blockade
(2:26:10)
Featuring the video recorded proceedings of events held in conjunction with important scientific symposia, live webcasts and closed meetings featuring the perspectives of renowned clinical investigators, these videos provide an overview of important advances in the management of a number of solid tumors and hematologic cancers.