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An innovative technology may catch this common breast cancer treatment complication earlier.

Preventing Lymphedema: What Patients Need to Know

Among patients with advanced castration-sensitive prostate cancer, health-related quality of life was not statistically different between those receiving Erleada (apalutamide) alone or in combination with Zytiga (abiraterone acetate) and prednisone compared with those receiving androgen-deprivation therapy (ADT) plus Zytiga and prednisone, according to findings in 

Health-related quality of life was evaluated using the Functional Assessment of Cancer Therapy–Prostate (FACT-P) questionnaire and its subscales. The questionnaire was completed at baseline and every four weeks until week 25. FACT-P scores range from 0 to 156, with higher scores indicating better quality of life, according to study authors.

There were no significant differences in baseline mean FACT-P total scores or subscales across the three treatment groups: ADT plus Zytiga and prednisone, 118.5; Erleada, 116.1; and Zytiga and prednisone plus Erleada, 114.9.

Health-related quality of life was maintained during the treatment period, with no statistically significant differences at 25 weeks in mean FACT-P total scores or subscales: ADT plus Zytiga and prednisone, 122.3; Erleada monotherapy, 119.5; and Zytiga and prednisone plus Erleada, 119.9.

The Erleada monotherapy and Zytiga and prednisone plus Erleada groups did not experience meaningful improvements in health-related quality of life compared with the ADT plus Zytiga and prednisone group, except in time to deterioration of the emotional well-being score. This outcome was more favorable in those who received Erleada alone, with a 63% reduction in risk compared with the ADT plus Zytiga and prednisone group, which had a 44% reduction in risk.

A prostate-specific antigen level of 0.2 nanograms per milliliter or lower at week 25 was observed in 31 of 41 patients (75.6%) in the ADT plus Zytiga and prednisone group, 24 of 40 patients (60%) in the Erleada monotherapy group and 31 of 39 patients (79.5%) in the Erleada plus Zytiga and prednisone group. The two-year overall survival rates were 92.5% for the ADT plus Zytiga and prednisone group, 87.9% for the Erleada monotherapy group and 92.7% for the Erleada plus Zytiga and prednisone arm.

Treatment-related side effects of any grade were reported in 30 of 42 patients (71.4%) in the ADT plus Zytiga and prednisone group, 34 of 42 patients (81%) in the Erleada monotherapy group and 36 of 44 patients (81.8%) in the Erleada plus Zytiga and prednisone group.

Grade 3 (severe) and 4 (life-threatening) treatment-related side effects occurred in eight of 42 patients (19%) in the ADT plus Zytiga and prednisone group, seven of 42 patients (16.7%) in the Erleada monotherapy group and 10 of 44 patients (22.7%) in the Erleada plus Zytiga and prednisone group. Lower rates of hot flashes and hypertension were reported in patients who received Erleada monotherapy.

Gynecomastia affected 23 of 42 patients (54.8%), and breast pain was reported by six of 42 patients (14.3%) in the Erleada monotherapy group, both higher than rates observed in the other two groups. No new safety signals were detected in
the study.

“Androgen Receptor Pathway Inhibitor Therapy for Advanced Prostate Cancer: Secondary Analysis of a Randomized Clinical Trial” by Dr. Diogo Assed Bastos et al., 

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In patients with advanced castration-sensitive prostate cancer, health-related quality of life (HRQOL) was similar across treatment groups receiving Erleada (apalutamide) alone, APA plus Zytiga (abiraterone acetate) and Deltasone (prednisone), or ADT plus AAP. The study, published in JAMA Network Open, found no significant differences in HRQOL scores at 25 weeks. However, the APA-alone group showed a more favorable time to deterioration in emotional well-being. PSA levels and overall survival rates were comparable, with varying side effect profiles across treatment groups.

A study found no significant HRQOL differences between Erleada-based therapies and ADT plus AAP for advanced castration-sensitive prostate cancer.

Tumor

Erleada Combo Shows Comparable Quality of Life Outcomes in Prostate Cancer

In a real-world setting, standard-of-care Carvykti (ciltacabta-gene autoleucel) has been shown to elicit responses from nearly all participating patients with relapsed/ refractory multiple myeloma (R/R MM).

Carvykti is a type of chimeric antigen receptor-T (CAR-T ) cell therapy, which, as explained by the National Cancer Institute, involves a patient’s T cells — part
of the immune system — being extracted, changed in a laboratory to attack cancer cells, grown in the laboratory and infused back into the patient.

Overall and complete response rates were 89% and 70%, respectively, in
all patients who received Carvykti, 94% and 74% in 191 patients who received conforming Carvykti and 95% and 76% in 152 patients treated with conforming Carvykti with fludarabine/ cyclophosphamide lymphodepletion.

A comforming treatment is administered according to the specifications of
the FDA’s approval, and lymphodepletion is a short course of chemotherapy administered before CAR-T cell therapy.

 for adults with R/R MM who had received at least four prior lines of treatment. In 2024, the agency approved Carvykti for patients who received at least one prior line of therapy.

, that led to the FDA’s 2022 approval of Carvykti, the overall response rate was 98%, with 83% stringent complete response, according to findings published in 2023.

Patients with R/R MM who underwent leukapheresis, or the collection of healthy white blood cells from a patient, for Carvykti manufacturing at 16 American academic medical centers were included in the study, published in Blood, with 255 patients undergoing leukapheresis and 236 receiving Carvykti.

Of the real-world patients, 54% would not have met the eligibility criteria for CARTITUDE-1.

Senior author Dr. Doris K. Hansen of Moffitt Cancer Center’s Department
of Blood and Marrow Transplant and Cellular Immunotherapy, explained in an interview with 

 why such real-world findings are significant.

“Clinical trials are invaluable because they serve as the gold standard for introducing new therapies and advancing science,” Hansen explained.

“However, clinical trials often have strict eligibility criteria. Patients must meet very specific criteria to participate — they need to have good organ function, stable blood counts and no significant comorbidities."

In contrast, Hansen said, the patients seen in day-to-day clinical practice often have a variety of health challenges, with many patients having comorbid conditions like cardiac issues or renal impairment, and with about 20% of those diagnosed with myeloma experiencing kidney problems. “Additionally,” Hansen said, “some patients may have plasma cell leukemia, amyloidosis or myeloma-related bone damage, which can lead to fractures, pain and even reduced mobility or wheelchair use. These factors often make patients ineligible for clinical trials. ... It is, therefore, very important to report on the experiences of these patients. By studying their outcomes, we can understand how treatments perform in real-world scenarios, as opposed to the controlled, ideal conditions of clinical trials.”

The eligibility criteria for CARTITUDE-1 included adequate organ function, limited comorbidities and having no prior exposure to B-cell maturation antigentargeted therapy.

Cytokine release syndrome was experienced by 75% of patients, with grade 3 (severe) or higher in 5%. Immune effector cell-associated neurotoxicity syndrome was seen in 14%, with grade 3 or higher in 4%. Delayed neurotoxicity was reported in 10% of patients.

Researchers reported a 10% nonrelapse mortality rate, mostly from infections, and noted that second primary malignancies, excluding nonmelanoma skin cancers, were seen in 5.5% of patients and myeloid malignancies/acute leukemia in 1.7%.

 such as Carvykti, as explained by the National Cancer Institute, involves a patient’s T cells, part of the immune system, being extracted, changed in a laboratory to attack cancer cells, grown in the laboratory and infused back into the patient. Carvykti is currently approved by the FDA to be administered in the second line of treatment.

Safety and Efficacy of Standard of Care Ciltacabtagene Autoleucel for Relapsed/Refractory Multiple Myeloma” by Dr. Surbhi Sidana, et al., 

Carvykti (ciltacabtagene autoleucel) demonstrates significant efficacy in real-world settings for relapsed or refractory multiple myeloma, with 89% of patients responding and 70% achieving complete response. Despite many patients not meeting clinical trial criteria, outcomes were comparable to the CARTITUDE-1 trial. At 13 months, median progression-free survival and overall survival were not reached, with 12-month estimates at 68% and 82%, respectively. Side effects included cytokine release syndrome and neurotoxicity. Carvykti, a CAR-T cell therapy, is FDA-approved for patients with multiple prior treatments.

The CAR-T cell therapy Carvykti has been shown to be effective among patients outside the confines of a clinical trial.

Carvykti Effective in Real-World Setting for Myeloma 

Among patients with stage 3 unresectable non-small cell lung cancer (NSCLC), the first participant has been dosed in the phase 2 CONVERGE study, according to a news release from biotechnology company Nanobiotix. The randomized, controlled clinical trial is evaluating the potential first-in-class radioenhancer JNJ-1900 (NBTXR3) in patients being treated with standard-of-care chemoradiation followed by consolidation Imfinzi (durvalumab).

“We believe the true value of [NBTXR3] is driven by its potential to address the unmet needs of the millions of patients each year who receive radiotherapy as part of their treatment,” said Laurent Levy, Chief Executive Officer and Chairman of the Executive Board at Nanobiotix. “With a clear path to potential registration in head and neck cancer established through NANORAY-312, the first patient dosed in the CONVERGE study in [non-small cell lung cancer] NSCLC brings us another step closer to delivering for the large number of patients [NBTXR3] is designed to serve.”

Who is Eligible For CONVERGE Study Enrollment?

According to the clinical trial page
at clinicaltrials.gov, CONVERGE is evaluating the addition of NBTXR3 to concurrent platinum-based doublet chemotherapy with radiation therapy, followed by consolidation immunotherapy, and whether this enhances the objective response rate in patients with locally advanced, unresectable stage 3 NSCLC.

To be considered eligible for enrollment, patients must be candidates for chemotherapy with radiation therapy; have a pathologically confirmed NSCLC diagnosis within three months prior to enrollment; present with unresectable stage 3IIIA or 3IIIB NSCLC; have at least one target lesion suitable for intratumoral or /intranodal injection and external beam radiation therapy; and have an ECOG performance status of 0 or 1.

Participants are considered ineligible for enrollment in the study if they have a history of primary immunodeficiency; organ transplantation requiring immunosuppression; significant cardiac events within three months before enrollment; concurrent or recent malignancies other than NSCLC; and known hypersensitivity to study drugs or components.

Patients with active bleeding diathesis or patients requiring anticoagulation or antiplatelet therapy that cannot be safely modified for procedures are also excluded.

The novel, potentially first-in-class oncology product NBTXR3 comprises functionalized hafnium oxide crystal nanoparticles administered via one-time intratumoral injection and activated by radiotherapy. The proof-of-concept for NBTXR3 was demonstrated in soft tissue sarcomas, leading to the agent receiving a European CE mark in 2019.

The agent’s mechanism of action is designed to induce substantial tumor cell death within the injected tumor when activated by radiotherapy, thereby triggering an adaptive immune response and establishing long-term anticancer memory. Consequently, the company anticipates that NBTXR3 could be applied to any solid tumor treatable with radiotherapy and be adaptable to any therapeutic combination, especially with immune checkpoint inhibitors.

The radiotherapy-activated NBTXR3 is under evaluation for multiple solid tumor indications as a stand-alone treatment and in combination with anti-PD-1 immune checkpoint inhibitors. These initiatives include the global, randomized NANORAY-312 trial, which is focused on locally advanced head and neck squamous cell carcinomas. In February 2020, the Food and Drug Administration granted fast track designation to NBTXR3 activated by radiotherapy, with or without Erbitux (cetuximab), for patients with locally advanced head and neck squamous cell carcinoma who are ineligible for platinum-based chemotherapy.

In 2019, the company entered a comprehensive clinical research partnership with The University of Texas MD Anderson Cancer Center to sponsor multiple phase 1 and 2 trials evaluating NBTXR3 across various tumor types and therapeutic combinations. Nanobiotix announced a license agreement with Janssen Pharmaceuticals, a Johnson & Johnson company, for the global co-development and commercialization of NBTXR3 in 2023.

The phase 2 CONVERGE study has commenced dosing its first participant to evaluate the radioenhancer JNJ-1900 (NBTXR3) in stage III unresectable non-small cell lung cancer (NSCLC) patients. This trial investigates the efficacy of NBTXR3 combined with standard chemoradiation and consolidation durvalumab. NBTXR3, a hafnium oxide nanoparticle, is activated by radiotherapy to induce tumor cell death and an adaptive immune response. The study aims to enhance objective response rates in NSCLC, with eligibility criteria including specific NSCLC stages and performance status, while excluding certain medical conditions.

The first participant has been dosed on the phase 2 CONVERGE study evaluating NBTXR3 in stage III, unresectable non–small cell lung cancer.

Breaking Down the CONVERGE Study of NBTXR3 in Stage 3 Unresectable NSCLC

The woman who raised me and I did not always see eye to eye. In fact, as two stubborn, opinionated characters we frequently bickered, challenged and exchanged choice words with one another. 

As I reflect on 25 years strong with Mom, here are some of my favorite words that we exchanged. We gave each other many cards over the past few years, one of which she had told me she looked for a long time searching for the right message to express her feelings. It reads:

"When you have a daughter who makes you proud, makes you laugh and, very often, makes your day ... you know what joy is. When you have a daughter who is a good person with a gracious heart and generous spirit ... you know what peace is. When you have a daughter whose beauty (inside and out) is matched only by her compassion for others ... you know what love is. Because I have you for my daughter, I know what it is to be truly blessed."

When I first read those words — as I read them now — I feel so close to my mom. Recently, I found a card with the words that expressed how I feel about her. I read this aloud to her on Christmas Day.

"Dear Mom, I'm so grateful for the way I was raised. You were never afraid to be my mother — to put your foot down, to teach me right from wrong, to make sure I did my best. You always let me know I had a mama who cared about me, who believed in me, who was there for me no matter what. Growing up with that kind of love and support made such a difference in my life; it made me who I am today."

My mother was never afraid to voice her opinion or be one to mince words, to put it lightly; but she was always pure in her intentions and true in her actions, and I feel so clearly, so humbly loved. As I go forward, I remember her strength and purity, her fierce sense of pride, her generous heart and sensitivity, her sense of humor (she once packed me a peanut-butter-jelly-and-ham sandwich because I refused to pick one of the two). 

Throughout her life and especially in her fight against lung cancer, Mom set us an example in unconditional devotion, taught our family valuable life lessons and never lost her indomitable spirit.

I know Mom is with us now and always. Goodbyes are only for those who love with their eyes, because for those who love with heart and soul there is no such thing as separation. I love you Mom, Happy New Year. Rest in peace and God bless.

For more news on cancer updates, research and education, don’t forget to

The narrative reflects on a complex yet deeply loving relationship between a daughter and her mother, characterized by mutual respect and understanding despite frequent disagreements. The daughter cherishes the heartfelt words exchanged through cards, highlighting the mother's pride, love, and unwavering support. The mother, who battled lung cancer, exemplified strength, devotion, and humor, leaving a lasting impact on her family. The daughter expresses gratitude for her upbringing and acknowledges the enduring connection with her mother, emphasizing that true love transcends physical separation.

A Tribute to Mom

The measures available for treating advanced melanoma were sparse in March 2011, when Yervoy (ipilimumab) became the first drug in 13 years to earn approval from the U.S. Food and Drug Administration (FDA) for treatment of the disease. Since then, the toolbox of drugs has rapidly expanded.

“In the last five years, there have been FDA approvals for 12 new agents and combination therapies for patients with advanced melanoma,” said Keith T. Flaherty, M.D., who moderated a Peer Exchange panel titled “Treatment of Advanced Melanoma and Basal Cell Carcinoma.” The panel was hosted over the summer by the website OncLive®, a sister publication to CURE®.

Novel melanoma treatments fall broadly into two categories. One encompasses agents that target cell signaling in the MAP kinase (MAPK) pathway, which is a chain of proteins inside a cell that transmits messages. The other category includes agents that target immune system proteins.

Several more melanoma treatments are poised to emerge from the pipeline. But even without additional advances, data on the optimal way to incorporate these novel drugs into practice lag far behind the breakneck pace of approvals. On the panel, experts in the field offered guidance based on their experience with the latest drugs.

What sets melanoma apart from other malignancies is its high mutational burden and immunogenicity, meaning its ability to react to certain substances by waging a strong immune response. Jeffrey S. Weber, M.D., Ph.D., explained how the interplay between these two factors makes melanoma highly susceptible to targeted therapies. “If you look at average mutational load, melanoma is No. 1 of all tumors, with a median of about 600 to 700 individual non-synonymous mutations,” he said.

Non-synonymous means the mutation is found only in tumor-cell DNA, where it encodes peptides and protein fragments not expressed by normal cells. This is important because melanoma grows from melanocytes, or pigmented skin cells, that have undergone dangerous changes, and one function of melanocytes is to present antigens, or foreign substances found in the body, to immune cells. When the melanoma melanocytes present the “alien” mutationencoded antigens to T cells, it triggers an immune response. “A lot of mutations means the cells grow out of control and make cancers, (but the cell) contains within it the potential seed of its own destruction…by the immune system,” Weber said.

Georgina Long, Ph.D., M.B.B.S., identified the three most common genetic drivers of melanoma as BRAF V600 mutations, NRAS mutations and NF1 alterations. Approximately 40 percent of patients with cutaneous melanoma (disease that occurs on the skin) have a BRAF mutation, up to 25 percent have an NRAS mutation and about 12 percent have an NF1 mutation. Other driver mutations include MEK1, KIT, CTNNB1 and GNAQ.

Long said BRAF V600 mutations are the most critical aberrations to test for when evaluating patients for treatment, since they are common and drugs exist that can target them. Long’s institution also routinely tests for RAS, NF1 and KIT aberrations, in case patients are eligible for clinical trials testing drugs that target those mutations. The frequency of driver mutations varies according to melanoma site and sun damage. As Jason J. Luke, M.D., explained, “There are melanocytic melanomas that can arise in other parts of the body, including acral lentiginous melanomas (which can occur on the palms or soles or under fingernails) or mucosal melanomas, as well as uveal melanomas (which occur in the eye), and we see a different mutational spectrum in those types of tumors.”

For example, while 40 percent of patients with cutaneous melanoma have a BRAF mutation, just 5 percent of patients with mucosal melanoma do. Conversely, 20 percent of patients with mucosal melanoma have a KIT mutation, compared with only 2 percent of patients with cutaneous melanoma. Clinical trials are evaluating therapies in melanoma patients that target mutations other than BRAF. “We haven’t cured melanoma, and there’s a lot of work still to be done,” Luke said.

Circling back to the interplay between mutational burden and immunogenicity, Luke said he and his colleagues are investigating whether certain genetic aberrations compromise the immune system’s ability to attack melanoma cells through pathway disruption. The findings could lead to novel targeted therapies that hone in on signaling pathways instead of driver mutations.

“The toughest issue right now in melanoma medical oncology (is) what to do with stage 3 patients,” Luke said. These are patients whose melanoma has spread to lymph nodes or lymphatic vessels in a region of the body close to the original cancer site. The first approach is excision of the primary tumor with wide margins and removal of regional lymph nodes.

Jonathan S. Zager, M.D., the lone surgeon on the panel, discussed how he weighs whether a patient with stage 3 or stage 4 (distant metastatic) melanoma is eligible for resection (surgery): Does the patient have bulky nodal disease or a tumor encroaching on an important vein or artery? “I can resect anything, but…you have to think about the functional and cosmetic consequences of the resection,” he said.

For patients with unresectable disease, clinicians must decide whether to use therapeutics to try to shrink the tumor until it becomes resectable; and for patients with resectable disease, clinicians must decide whether using an adjuvant, or post-therapy, regimen to reduce the chances of recurrence outweighs its toxicities. Outside of a clinical trial, the choice between targeted mutation therapy versus immunotherapy hinges on whether the tumor has a BRAF mutation.

According to Zager, BRAF inhibitors shrink unresectable melanoma faster than immunotherapy in patients with a BRAF mutation. “The tumor doesn’t have to go away — it just has to make surgery easier for the surgeon and for the patient,” he said. In the adjuvant setting, acquired resistance is a concern with targeted mutation therapies, but it’s less of a worry in the neoadjuvant, or pre-treatment, setting. Long said, “In the neoadjuvant setting, where you’ve got a patient and you need a quick reduction, you don’t worry so much about acquired resistance.”

For tumors that do not have BRAF mutations, Zager said he often uses the vaccine T-VEC. In a phase 3 trial that included patients with unresected stage 3b to 4 melanoma, T-VEC produced a significantly better durable response rate than a different immune-stimulating drug, granulocyte macrophage colony-stimulating factor (16.3 percent versus 2.1 percent, respectively). “It’s extremely well-tolerated,” he said, describing adverse effects as similar to mild or moderate flu symptoms that last for one or two days after injection.

Zager said T-VEC is a great option for patients who cannot or will not use systemic therapy. Weber described T-VEC as something of a “niche drug” that can help prime an immune response before administering a PD-1 checkpoint inhibitor alone, or added to other immunotherapies.

Immunotherapy combinations have shown good efficacy in trials, and the FDA has approved Yervoy plus Opdivo for patients with BRAF-positive disease. Long reviewed results from the phase 2 CheckMate-069 trial, which assessed a Yervoy/Opdivo combination in patients with stage 3 unresectable or stage 4 metastatic melanoma.

At the 2016 Annual Meeting of the American Association for Cancer Research, investigators reported that the two-year overall survival (OS) rate was 64 percent overall and 69 percent in patients whose melanoma did not include a BRAF mutation. “This is pretty incredible stuff,” Long said.

Ongoing trials are attempting to combine a BRAF inhibitor with immunotherapy. Luke said early data from phase 1 trials of such combinations have indicated lackluster response rates.

The panel had a spirited discussion about the risks and benefits of adjuvant high-dose Yervoy. In October 2015, the FDA expanded Yervoy’s indications to include a 10 mg/kg adjuvant regimen for completely resected melanoma in patients with cancer that had spread to lymph nodes near the original site, and was larger than 1 mm in those nodes. Approval was based on findings from a phase 3 trial that randomly assigned adults with stage 3 melanoma to highdose Yervoy (n = 475) or placebo (n = 476). Participants were required to have undergone complete resection and to have never received prior systemic therapy. Median recurrence-free survival was significantly longer in the Yervoy arm than in the placebo arm (26 months versus 17 months, respectively).

“That’s a 25 percent reduction in the risk of recurrence,” said Long, whose home country of Australia has not approved the adjuvant regimen. She also noted that OS data were not yet mature; but since then, updated findings from the trial demonstrated that, at a median of 5.3 years’ followup, the five-year overall survival rate was 65.4 percent with Yervoy compared with 54.4 percent in the control arm. Long pointed out that the high dose used in the trial was very toxic. Five treatment-related deaths occurred during the trial, but Weber noted that there were fewer deaths over time with Yervoy than in the placebo arm.

Although the two experts disagreed over the meaningfulness of the on-study deaths, they agreed that clinicians must weigh the study’s findings cautiously when making treatment decisions. Long said she doubted Australian oncologists would find that the benefits of using highdose Yervoy outweighed the serious risks.

Luke said that, even if the trial found an OS benefit with high-dose Yervoy, he was not sure the toxicities, some of which could make patients ineligible for subsequent therapies, would be worth it. “There are ongoing trials investigating agents in this space, so I would really prioritize the idea that patients should participate in those,” he said.

The paradigm for patients who have unresectable metastases is still evolving. Luke said the thinking used to be that mutation-targeting therapy was more suitable for high-volume BRAF-positive melanoma, which might be symptomatic, and that immunotherapy was better for low-volume disease. “I think our recent data are starting to say that at least there’s equipoise, or perhaps it’s the reverse,” he said. Luke explained that newer data show patients with less than three sites of disease, normal lactate dehydrogenase (LDH) levels (which indicate the health of the body's tissues) and good performance status have better longterm outcomes with mutation-targeting therapy than those with bulky disease. Recent studies have also found that patients with bulky disease and higher LDH levels fare better with immunotherapy combinations than many other patient groups.

On the mutation therapy front, Long discussed longterm data from the phase 3 COMBI-d trial that included 423 people, randomly assigning patients with BRAFpositive metastatic melanoma to Tafinlar plus Mekinist or to Tafinlar monotherapy. “The three-year survival in a normal LDH patient on dabrafenib and trametinib is 70 percent,” Long said. The panel concurred that trials of new immunotherapy regimens should perform posthoc analyses of OS data by LDH level and that, going forward, trials should include LDH breakdowns in their protocols.

“We need targeted therapy options for other patients,” Flaherty said. He brought up binimetinib, a MEK inhibitor being studied in patients with NRAS mutations. Long said a phase 3 study that compared binimetinib with the chemotherapy dacarbazine showed benefits in progression-free survival and response, but not in OS. “But it is a wonderful foundation, because there’s definitely a signal there,” she said. MEK inhibition also disrupts signaling along the MAPK pathway, which Long noted is “constitutively active in the majority of melanomas, even if they’re not BRAF-mutated.” Other molecular targets being explored are CDK4/6 and CDKN2A.

“Melanoma is an exciting cancer that’s really forging the way of treating cancer in a novel way. I’m really keen to continue to pursue that with clinical trials of novel combinations, because I would like to see the melanoma cure rate increase,” Long said, adding that she believes about one-third of patients are being cured.

Luke predicted that the best is yet to come, but said that progress depends on patients participating in clinical trials. Weber urged trial sponsors to let investigators mine their clinical trial data, which could lead to new discoveries.

The treatment landscape for advanced melanoma has significantly evolved since the approval of Yervoy in 2011, with 12 new agents and combination therapies approved in recent years. These treatments target either the MAP kinase pathway or immune system proteins. Melanoma's high mutational burden and immunogenicity make it particularly responsive to targeted therapies. The management of advanced melanoma involves complex decisions regarding surgical resection, adjuvant therapies, and systemic treatments, with ongoing research into novel targeted therapies and immunotherapy combinations. Clinical trials remain crucial for advancing treatment options and improving patient outcomes.

Growing scientific insights have led to the swift development of treatments for advanced melanoma, leaving doctors to iron out details about their application.

Pat Whitworth, MD

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