ESMO Asia 2025 | Challenges and opportunities in managing acral melanoma
Yasuhiro Nakamura, MD, PhD, Saitama Medical University International Medical Center, Saitama, Japan, discusses the challenges of treating acral melanoma due to its low tumor mutation burden, which limits the efficacy of immunotherapy. Promising results of a novel combination therapy consisting of a PD-1 inhibitor, axitinib, and temozolomide, has shown a high response rate and prolonged progression-free and overall survival in recent clinical trials. This interview took place at 2025 European Society for Medical Oncology (ESMO) Asia Congress in Singapore, Singapore.
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Transcript
Yeah, so then as for an acral melanoma treatment, it’s very difficult to feel because the patient has a very low tumor mutation burden, which will lead to the low clinical efficacy of immunotherapy, unfortunately. So in the recent update of the NCT clinical trials, particularly from China, shows very promising data regarding the novel combination of, for example, PD-1 plus axitinib...
Yeah, so then as for an acral melanoma treatment, it’s very difficult to feel because the patient has a very low tumor mutation burden, which will lead to the low clinical efficacy of immunotherapy, unfortunately. So in the recent update of the NCT clinical trials, particularly from China, shows very promising data regarding the novel combination of, for example, PD-1 plus axitinib. Axitinib is a VEGF receptor inhibitor. And the conventional chemotherapy agent, temozolomide, showing a higher response rate at over 60% and prolonged progression-free and overall survival. This will now be confirmed by using the phase 3 clinical trials, three arms of the triplet therapy and doublet PD-1 plus axitinib and PD-1 plus RO arm, or the PD-1 single arm. This will be very promising data in this field of advanced setting treatment.
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