Charles L. Sawyers, MD, discusses the value of atezolizumab, cobimetinib, and vemurafenib in the melanoma treatment landscape.
Charles L. Sawyers, MD, internist and hematologic oncologist; chair of the Human Oncology and Pathogenesis Program; and Marie-Josée and Henry R. Kravis Chair at Memorial Sloan Kettering Cancer Center, discusses the value of atezolizumab (Tecentriq), cobimetinib (Cotellic), and vemurafenib (Zelboraf) in the melanoma treatment landscape.
The phase 3 IMspire150 trial (NCT02908672) investigated this triplet regimen in patients with previously untreated patients with metastatic or unresectable locally advanced melanoma and a BRAFV600 mutation. The trial showed efficacy of this triplet regimen by meeting its primary end point of progression-free survival (PFS). Sawyers says that although it is great that it worked for these patients, the field has moved forward at a rapid pace.
Although the comparison in this trial was compelling at the time it was designed, it’s now troubling because the standard of care for these patients is ipilimumab (Yervoy) and PD-1/PD-L1 antibodies, which has shown impressive efficacy in early trials and in a 5-year follow-up, according to Sawyers. About 40% of patients have PFS at 5 years, which may be hard to surpass with the IMspire150 trial. Comparisons of these 2 types of regimens are moving forward in this setting.