ESMO 2026 | Lifileucel shows superior efficacy vs PD-1/LAG-3 inhibition in melanoma

Yes, so one of the big questions in the field these days with the treatment of patients with advanced cutaneous melanoma is what to do when patients have already been previously treated with PD-1-based checkpoint inhibition and what to do in the relapsed or refractory setting. One option is to use tumor-infiltrating lymphocyte therapy, TIL or lifileucel, which is now FDA-approved in the United States. But besides TIL, for patients who have been treated previously with either PD-1 monotherapy or dual checkpoint blockade with PD-1 and CTLA-4, there’s the PD-1 plus LAG-3 combination of Opdualag. And so what we wanted to do is try to understand which of those might be better in the relapsed setting. There’s no trials that directly compare those two therapies. And so, what we tried to do was compare some of the data that’s available from patients treated on both of those respective trials. The C-144-01 study in the case of lifileucel, which was the registrational trial, and then the RELATIVITY-020, which is looking at PD-1 and LAG-3 in the refractory setting. And so we took patients from both of those studies, performed what we called a MAIC, or matched-adjusted indirect comparison study, to try to look at those patients. And what we wanted to see is if there might be an obvious benefit to one therapy over the other. And this study showed that lifileucel, when patients were matched and weighted, it did appear to be better, both in terms of overall response rate, and then also progression-free and overall survival, although that was not statistically significant.

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