The future of melanoma treatment will include many combinations, explained Mario Sznol, MD, professor of medicine and co-leader of cancer immunology at the Yale Cancer Center.
There will be other drugs that will come in to the clinic. I mentioned before that T-VEC is being used in combination with pembrolizumab (Keytruda). Those phase III trial results will be out hopefully in the near future. There are phase III trials ongoing with modified cytokines, like the NKTR-214 drug together with nivolumab (Opdivo) compared to nivolumab alone. There's a phase III trial comparing a VEGF receptor inhibitor with pembrolizumab versus pembrolizumab alone. There are probably other phase III trials that I don't even know about that are combinations comparing to single-agent anti-PD1.
There are things that are being used in the second- and third-line that are also investigational like TIL (tumor-infiltrating lymphocyte) therapy that could be interesting. There are new drugs like anti-CD40 that have shown activity in the refractory setting, drugs like anti-LIG3 that are all being used in combination with anti-PD–1. So eventually, there will be additional combinations that will be used either in the frontline setting or in the second-line setting that we hope will move up that survival curve.