Abstract Number: 12

New horizons in melanoma management

G.A. McArthur

Meeting: 2014 Dermcoll

Session Information

Date: -

Session Title: Melanoma Symposium 1

Session Time: -

The understanding of the key molecular events controlling
the hosts immune response to cancer and the in depth
understanding of the cellular and molecular biology of
melanoma have led to major changes in the therapeutic
paradigm in metastatic melanoma. There are now a large
number of immunological targets that can be modulated by
therapeutic antibodies to stimulate a host immune response
against tumours. The CTLA4-inhibitory antibody
ipilimumab can improve overall survival in patients with
advanced disease leading to 20% of patients obtaining longterm
clinical benefit. Even more promising are antibodies
to the programmed death-1 receptor (PD-1) or its ligand
PD-L1 that generate responses in an even higher proportion
of patients. The melanoma genome is now well annotated
with over 60% of patients having genomic events that activate
RAS/RAF/MEK/ERK pathway. This has led to systemic
therapies that improve overall survival in the advanced
disease setting, and potentially offer even more significantimpact in the adjuvant setting. Perhaps the greatest promise
to impact mortality from melanoma, a disease characterized
by the development of metastases from small primary
tumours, is the combination of systemic therapies. The new
systemic therapies for melanoma have generated a paradigm
shift in the management of patients with metastatic
disease and are poised to transform care in the adjuvant
setting if clinical trial data from adjuvant studies shows
similar results to patients with advanced disease.