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New treatments. Reached a plateau?
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New treatments. Reached a plateau?

› Forums › General Melanoma Community › New treatments. Reached a plateau?

  • Post
    • October 28, 2021 at 5:01 am
    tim brown
    Participant
      • When I was diagnosed with metastatic melanoma in April 2019, my oncologist made great play of the fact that if surgery was unsuccessful, checkpoint inhibition was a wonderful resource which had transformed the treatment of the disease. No argument there.
        20 months later, I view the landscape differently. Firstly, there has been a degree of ‘smoke and mirrors’ in terms of efficacy. Surrogate markers used to extrapolate the most important yardstick, Overall Survival OS) have been misleading and a stubborn 60 a 65% of patients derive limited or no benefit.

      Secondly, aside from Relatlimab (anti LAG 3),  most new checkpoint inhibition targets have shown disappointing results.

      Lack of predictive bio markers for advanced treatment options is another area of under achievement.

      My basic question is where’s the new thinking? In an age where  we are told that A.I. has started to make significant inroads into curative medicine, where and how can melanoma treatment benefit?

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        • October 28, 2021 at 11:02 am
        ed williams
        Participant
          Tim, consider checkmate -037 early 2002-3 time line of Ipi and the development took years to go through process before given to humans. Early 2011 approved after 8 years of clinical trials. Nivo (Opdivo) development approved 2015 also took years from mice to humans to approval. lag-3 (Relatlimab) now at FDA also took years to go through process. TIL’s process with Lifucels LN-144 also years in development and is now at the FDA. now I don’t want to get into the weeds to much but there are hundreds of fails that don’t get the press except maybe IDO inhibitors combined with Pembro, because they jumped way to fast to stage 3 and blew up as a major failure and cautionary tale to big pharma!  here is a good read from Jedd Wolchok of Memorial Sloan Kettering written in 2013 to put thing in perspective. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910157/
            • October 28, 2021 at 11:10 am
            ed williams
            Participant
              Tim, 2011 is when I got into this crazy melanoma world and I think the progress has been amazing. I was reading Facebook posts back then from families doing just about anything and everything to try and get access to a then lettered drug with no name that eventually would be called Nivolumab, then once approved Opdivo. save Locky’s dad comes to mind. https://www.youtube.com/watch?v=qznB5n0F1JA
            • October 28, 2021 at 11:26 am
            tim brown
            Participant
              Hi Ed,
              I’m not in disagreement about any of this – perhaps it’s because I appear to be in the 60+% immune checkpoint failure group that I think the thrust of my question is a valid one for open debate. (Add on the almost complete lack of progress for those 15-20% who are saddled with the NRAS mutation.)
              Best,
              Tim
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