ESMO 2021 | Anti-PD1 monotherapy or combination with ipi after BRAF/MEK inhibitors in BRAF-mutant melanoma

Ines Pires da Silva, MD, PhD, Melanoma Institute Australia and The University of Sydney, Sydney, Australia, discusses the use of anti-PD1 monotherapy or in combination with ipilimumab after the use of BRAF/MEK inhibitors in patients with BRAF mutant metastatic melanoma. Dr da Silva firstly details the characteristics of the patients included in this study as well as its endpoints and reports that overall, there is a trend towards benefit for the combination therapy. However, this difference is not statistically significant. In addition, analysis of patients with an overall survival (OS) greater than 3 years confirmed that three main clinical factors can help predict which patients will survive in the long term. Those factors include an ECOG performance status of 0, absence of liver metastases, and normal LDH levels. Furthermore, subgroup analyses showed that patients with BRAF mutations other than V600E, patients who were treated with immunotherapy very shortly after treatment with BRAF/MEK inhibitors, patients with lower stage breast cancer, and females actually showed a trend towards benefit for PD-1 monotherapy, although non-significant. Finally, this study showed an expected toxicity profile, with patients treated with combination therapy experiencing more high-grade toxicities than patients treated with monotherapy. This interview took place at the European Society for Medical Oncology (ESMO) 2021 congress.