Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland, said the study was well designed, well conducted, and addressed an important clinical question “at the time of its inception.” But he agreed with Dr. Ascierto that “the evolving melanoma treatment landscape makes the study population less in line with our daily practice today.”
“Nevertheless,” he added, “the study brings very important information from an immunologic and clinical standpoint and will be key for the design of subsequent trials.” He further noted that the 31% of patients alive at year 3 in the experimental arm (10 mg/kg) is “highly encouraging.”
CA184-169 shows that “the more you push, the more you get, and this was not necessarily expected,” he added. The next research questions will be, “How much more can one push, and can the efficacy/toxicity profile be modified?” he said. It is possible, he suggested, that better handling of immune-related adverse events, “smarter” immunosuppression, and second-generation CTLA-4 (cytotoxic T-lymphocyte–associated protein 4) blockers can have a positive impact.
“The data of CA184-189 reinforce ipilimumab [Yervoy] as an essential component of our toolbox,” he emphasized, “and will help us build the next-generation treatment for melanoma.” ■
Disclosure: Dr. Michielin reported no potential conflicts of interest.
There has been debate as to the optimal dose of single-agent ipilimumab (Yervoy) in metastatic melanoma. A phase III study presented at the 2016 European Society for Medical Oncology (ESMO) Congress—the first to directly compare these doses—concluded that 10 mg/kg is more effective, but also more...