Melanoma treatments Past Present and Future Prof Jacob
Melanoma treatments Past, Present and Future Prof. Jacob Schachter The Ella Lemelbaum Institute for Immuno-Oncology and Melanoma Sheba Medical Center, Tel-Hashomer, ISRAEL January 2020
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Pooled OS Data for Dabrafenib/Trametinib From COMBI-d and COMBI-v Robert C et al. N Engl J Med. 2019. doi: 10. 1056/NEJMoa 190405.
5 -Year OS for Patients with Advanced Melanoma Treated with Pembrolizumab Hamid et al. ASCO 2018
The Sinergy of the Immune Combination Therapy Combination Survival Monotherapy ? Time Control Immune checkpoint blockade Combinations/sequencing 1. Adapted from Ribas A. Presented at: WCM; 2013. 2. Ribas A, et al. Clin Cancer Res. 2012; 18: 336 -341. 3. Drake CG. Ann Oncol. 2012; 23(suppl 8): viii 41 -viii 46.
Check. Mate 067 Nivolumab+ Ipilimumab Combination Checkmate 067 - Overall Survival – 5 Years 100 • Improved OS with NIVO+IPI and NIVO vs IPI over 5 years 90 Median OS, mo (95% CI) HR (95% CI) vs IPI 80 HR (95% CI) vs OS (%) 70 NIVO (n = 316) IPI (n = 315) NR (38. 2‒NR) 36. 9 (28. 2‒ 58. 7) 19. 9 (16. 8‒ 24. 6) 0. 52 (0. 42‒ 0. 64) 0. 63 (0. 52‒ 0. 76) – 0. 83 (0. 67‒ 1. 03) – – 64% 58% 60 59% 50 52% 40 45% 30 34% 20 53% 46% 30% NIVO+IPI 10 52% HR = 0. 83 (95% CI, 0. 67– 1. 03) 44% 26% NIVO IPI 0 0 3 6 9 12 15 18 245 227 222 210 231 214 201 203 181 163 No. at risk NIVO+IPI 314 NIVO 316 IPI 315 a. Descriptive NIVO a NIVO+IPI (n = 314) 292 265 292 266 285 253 analysis. Larkin J, et al. Oral presentation at the ESMO Annual Meeting 2019 21 24 27 30 33 36 39 42 45 48 51 54 57 Months 60 63 66 201 199 193 187 181 191 181 175 171 164 148 135 128 113 107 150 130 73 179 172 169 164 158 150 145 142 100 95 94 91 163 141 87 159 157 155 139 137 135 84 81 77 92 78 36 14 14 12 69 0 0 0
Survival by Disease Stage per AJCC 8 th Editiona Stage III melanoma 1 Proportion of survival rate 1. 0 IIIA (n = 1006) 0. 9 IIIB (n = 1170) 0. 8 0. 7 IIIC (n = 2201) 0. 6 0. 5 0. 4 IIID (n = 205) 0. 3 0. 2 0. 1 0 0 a. Based 1 2 3 4 5 6 Years 7 8 9 10 on AJCC 8 th Edition International Melanoma Database. b. Retrospective review of clinical records at Memorial Sloan Kettering Cancer Center between 1992 and 2004 1. Adapted from Gershenwald JE, et al. CA Cancer J Clin. 2017; 67: 472 -492. 2. Romano E, et al. J Clin Oncol. 2010; 28: 3042 -3047
Immunotherapy / Targeted Therapy in the Adjuvant Setting Adjuvant Nivolumab vs Ipilimumab in Resected Stage III / IV Melanoma 1 Adjuvant Pembrolizumab vs Placebo in Stage III Melanoma 2 Adjuvant Dabrafenib+Trametinib vs Placebo in Resected Stage III Melanoma 3 1. Weber et al. NEJM 2017 2. Eggermont et al. NEJM 2018 3. Long et al. NEJM 2017
To my humble opinion….
Thank you!
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