Clinical activity of anti-programmed death-1 (PD-1) agents in acral and mucosal melanoma. ASCO 2016. #9516. J Clin Oncol 2016. Munhoz, Shoushtari, Kuk, et al.
Here, the roughly 40% response rates with anti-PD1 for treatment naive cutaneous melanoma patients were not achieved. But, 85% of these patients had been previously treated....something many studies shows diminishes response rate and then there is the fact we are dealing with mucosal and acral melanoma. Response rates of 23 and 32% are certainly something and definitely worth pursuing!!! Interestingly, mucosal melanoma can often be NRAS positive. Earlier I posted this: Good news for NRAS positive folks re: Anti-PD1 In that report, where NRAS positive patients were evaluated for response to IL2, ipi, vs anti-PD1 they found:
"Within specific immune therapy types, patients with NRAS-mutant melanoma experienced the greatest benefit in CR/PR compared to patients with WT melanoma when treated with anti-PD1/PD-L1 agents (70% vs 20%)."
Which got me thinking: "A ray of light for folks with NRAS mutation. And maybe one more reason not to make them go through ipi before they get to take anti-PD1???!!!!!"
Not all mucosal or acral melanoma are NRAS positive...but that info would probably be a good thing to find out! Hang in there, dear ones! Hang in there. - c