RE: SCLP Tweet20 Nov 2018 15:00
Why tout for Mucosal Melanoma trial funding in China?... think it was a wise move
https://www.healio.com/hematology-oncology/melanoma-skin-cancer/news/online/%7Bd72811fb-f228-4512-be0b-07d727720345%7D/major-need-exists-for-more-effective-mucosal-melanoma-treatments
'Mucosal melanoma — prevalent in Asia — accounts for only 1.3% of all melanomas in the Western population. This incidence rate appears stable.
Median age at diagnosis is 70 years, and incidence is more common among black and Asian individuals.'
Mucosal melanoma is associated with a poorer prognosis than cutaneous melanoma. An estimated 50% to 90% of patients who undergo surgery experience recurrence. Only 25% of those with localized disease survive 5 years.
“Because these melanomas are not on the surface of the skin, they often are diagnosed when patients develop symptoms, so they are detected late,” Hauschild said.
Eighty-six patients received monotherapy with 3 mg/kg nivolumab (Opdivo, Bristol-Myers Squibb); 35 patients received combination therapy with 1 mg/kg nivolumab plus3 mg/kg ipilimumab (Yervoy, Bristol-Myers Squibb); and 36 patients received ipilimumab monotherapy dosed at 3 mg/kg.
Researchers reported significantly longer PFS among patients treated with the combination (median, 5.9 months; HR = 0.42; 95% CI, 0.23-0.75) or nivolumab monotherapy (median, 3 months; HR = 0.61; 95% CI, 0.39-0.96) compared with ipilimumab monotherapy (median, 2.7 months).
Six patients — five (5.8%) who received nivolumab monotherapy and one (2.9%) who received the combination — achieved complete response. Thirty patients — 15 (17.4%) who received nivolumab alone, 12 (34.3%) who received the combination and three (8.3%) who received ipilimumab alone — achieved partial response.
“Immunotherapy, for me, is the new standard of care,” Hauschild said. “At our center, if possible, we bring all patients with metastatic mucosal melanoma to ipilimumab plus nivolumab. … Targeted therapies might have a role, but new German guidelines on melanoma say they are for second-line treatment only. First-line is immunotherapy.” – by Mark Leiser
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