Therapy Trends KOL Insight: Malignant Melanoma [2018]

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Publication Date:
October 2018
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What developments are on the horizon for malignant melanoma?

The introduction of novel targeted systemic therapies has provided clinicians with valuable interventions for the treatment of malignant melanoma, however there is still a great demand for improved therapeutic options. Innovative small-molecule and biologic therapies are progressing through late-stage development, but in a competitive landscape which products will stand out?

Learn how KOLs see the malignant melanoma market evolving in Therapy Trends KOL Insight: Malignant Melanoma. Twelve of the world’s leading KOLs from the US and Europe provide candid insights on 11 marketed and 6 pipeline therapies targeting various aspects of the malignant melanoma treatment algorithm.

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Top takeaways

  • Will Merck & Co.’s Keytruda maintain its position as the leading anti-PD1 agent? In March 2018 Opdivo’s new Q4W dosing schedule was approved but how will it impact Keytruda?
  • Will Yervoy (BMS) toxicity spell the end of the therapy? BMS is exploring lower-dose regimens for the drug but will they be effective; what do experts think?
  • Checkpoint inhibitors dominate the melanoma landscape, but moving forward how can Merck & Co. and BMS protect their franchises? What advice do KOLs offer and which combination partners show the most promise?
  • BRAF/MEK combinations are usually preferred in BRAF-mutant patients but which combinations do KOLs favour and why? GSK’s Mekinist/Tafinlar enjoys first-to market advantage but how do KOLs see its future?
  • Is there room for a new BRAF/MEK combination? Array’s Braftovi/Mektovi combination has recently been approved. As the latest entrant in this space, can it compete?
  • Is there a future for Amgen’s Imlygic? Viewed as a niche product by experts, can combination therapy with immune-oncology agents rescue the oncolytic viral therapy?
  • How do KOLs rate the potential of BMS’ anti-LAG3 antibody, relatlimab, and its combination with Opdivo? Can anti-LAG3/PD1 combinations supplant anti-CTLA4/PD1 combinations?
  • What do experts think about Idera’s TLR9 agonist, tilsotolimod? Tilsotolimod/Yervoy combination is being evaluated in ILLUMINATE-301 for advanced melanoma but can it provide a breakthrough?
  • How do KOLs view Novartis’ spartalizumab and Roche’s atezolizumab? Experts believe anti-PD1 agents will form the backbone of future treatments but how do these novel therapies compare to Keytruda/Opdivo?
  • Triple anti-PD1/BRAF/MEK combinations are looming but which multi-drug regimens, according to KOLs, hold the greatest promise? What factors will determine their place in the treatment algorithm?
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“I think the immune checkpoint [inhibitors], for which we don't yet have adequate data, are another key area that needs to be explored. Obviously, immune checkpoints have had a major impact [success] in melanoma but we've only looked at two of them and there are another 10 others, so we need to explore those as well.”
EU Key Opinion Leader

“We have made great advances in [the treatment of] melanoma in the last few years. In five years from today, I definitely think that novel agents, or combinations and sequences, will give us the opportunity to increase [clinical outcomes by] an additional 20 percent of what we can get in the treatment of metastatic melanoma.” 
EU Key Opinion Leader


Sample of therapies covered

Marketed Therapies

  • Braftovi (encorafenib; Array BioPharma/Pierre Fabre)
  • Cotellic (cobimetinib; Exelixis/Roche)
  • Imlygic (talimogene laherparepvec; Amgen)
  • Keytruda (pembrolizumab; Merck & Co.)
  • Mekinist (trametinib; Novartis)
  • Mektovi (binimetinib; Array BioPharma/Pierre Fabre)
  • M-Vax (melanoma vaccine; AVAX Technologies)
  • Opdivo (nivolumab; Bristol-Myers Squibb/Ono Pharmaceutical)
  • Tafinlar (dabrafenib; Novartis)
  • Yervoy (ipilimumab; Bristol-Myers Squibb)
  • Zelboraf (vemurafenib; Roche/Genentech/Chugai)

Pipeline Therapies

  • Atezolizumab (Genentech/Roche)
  • Darleukin (Philogen)
  • Relatlimab (Bristol-Myers Squibb/Ono Pharmaceuticals)
  • Seviprotimut-L (Polynoma)
  • Spartalizumab (Novartis)
  • Tilsotolimod (Idera Pharmaceuticals)

KOLs interviewed

KOLs from North America

  • Kim A. Margolin, MD, Medical Oncologist, Clinical Professor, City of Hope, Department of Medical Oncology & Therapeutics Research, University of Washington, Seattle, WA
  • Michael Atkins, MDOncology Specialist, MedStar Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC
  • Rene Gonzalez-Catarelo, MD, Oncology Specialist, Memorial Hospital and University of Colorado Hospital, Aurora, Denver, CO
  • Roger S. Lo, MD, PhD, Assistant Professor, Medicine and Molecular & Medical Pharmacology, Department of Medicine at University of California at Los Angeles (UCLA), Los Angeles, CA
  • Sanjiv S. Agarwala, MD, Professor, Temple University School of Medicine, Chief of Medical Oncology and Hematology, St. Luke’s University Hospital & Health Network, Bethlehem, Philadelphia, PA
  • Vernon K. Sondak, MD, Oncology Specialist, Professor, Moffitt Cancer Center and University of South Florida Morsani College of Medicine, Tampa, FL

KOLs from Europe

  • Ana Arance, MD, PhD, Professor, Department of Medical Oncology, Hospital Clínic Barcelona, Spain
  • Anonymous German KOL, Prof. Dr., Oncology Specialist and Professor of Dermatology at a teaching hospital, Germany
  • Anonymous German KOL, Prof. Dr., Professor of Dermatology and Director at a teaching hospital, Germany
  • Michele Maio, MD, Professor & Director, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Italy
  • Paolo A. Ascierto, MD, Director at the Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, National Tumor Institute ‘Fondazione G. Pascale’, Naples, Italy
  • Paul D. Nathan, MBBS, PhD, FRCP, Consultant Medical Oncologist, Mount Vernon Cancer Centre, East and North Herts NHS Trust, Northwood, UK

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