March Reads ~ Voltaire, O'Conner, Robbe-Grillet, and Ayme!

Continuing the Bentie Reads Aloud tradition, he read me:

Candide - Voltaire.  COULD anything else happen to Candide? [To be read with Chandler Bing inflections!!!]  A tale much like that told in The Merry Minuet - "They're rioting in Africa.  They're starving in Spain.  There's hurricanes in Florida.  And Texas needs rain.  The whole world is festering with unhappy souls.  The French hate the Germans, the Germans hate the Poles.  Italians hate Yugoslovs, South Africans hate the Dutch. And I don't like anybody very much."  Some bemoaned their fate, others were oblivious.  Some thought things could only get better, while others were convinced the worst was yet to come.  Still others stoically soldiered on.  Hmmm...

Wise Blood - Flannery O'Conner.  Shew wee!  Some strange peeps populated this one.  Seemingly at odds (Or is it???) with someone who became obsessed with spreading the gospel of his Church Without Christ, Hazel Motes starts the practice of self-flagellation by walking in rock filled shoes at an early age and it just gets more intense from there.  Then there is Enoch Emery, a young man filled with anger and angst, who believes his wise blood leads him where he needs to go - even if that is to steal a mummified dwarf and possibly kill a man (?) in order to obtain his gorilla suit.  However, his outcome is never revealed.  B's take on it all - "Thank goodness that's over."  Me - "But, what happened to Emery? What about the man Motes killed?  And what was with that policeman?"  B - "I don't care!!!!"

From another of B's English/French short story collections there were also these:

The Beach - Alain Robbe-Grillet.  French short story.  Repetitive in the extreme.  But, yes.  I did see the three children, dressed alike, in blue shirts and shorts, walking in a straight line down the beach.  Looking neither left to the sharp cliff nor right to the undulating sea, where the foam came and dissipated on the swells, while the the sea birds fluttered up only to settle down a few yards beyond.   I saw and felt the scene through the sounds.

The Seven-League Boots - Marcel Ayme.  (Author of The Passer-Through-Walls)  With fantastic imagination, Ayme tells this story through the eyes of a boy (maybe aged ten) who lived and attended school on Montemarte with well-to-do classmates, though his mother worked as a domestic.  Social injustices and the effect of bullies on others as a theme continues in this well crafted short story, much like his other.

Read (or be read to) chaotically! ~ les

FDA approves Relatlimab plus Nivolumab (Opdivo) for advanced melanoma patients - the down and dirty on Opdualag!!!!

Finally, an additional FDA approved treatment for melanoma!!  With FDA approvals for the first immunotherapy and targeted therapy in melanoma in 2011, the addition of Nivo and Pembro in 2014, a few additional BRAF/MEK combo's in 2013 and 2018, T-VEC approved as an intralesional in 2015, immunotherapy approved as adjuvant in 2017, targeted as such in 2018 - that's been about it for new melanoma therapies.  I recently reported on study results for Relatlimab combined with Nivolumab (Opdivo) for treatment of advanced melanoma in February:  Relatlimab plus Nivolumab in advanced melanoma patients - better than Nivo (Opdivo) alone!  The main take-away from the data being:

1.  The combination of the anti-LAG-3 product relatlimab with anti-PD-1 agent Nivolumab provided better progression free survival than when melanoma patients with advanced disease were treated with nivo alone - "The median progression-free survival was 10.1 months (6.4 to 15.7) with relatlimab-nivolumab as compared with 4.6 months (3.4 to 5.6) with nivolumab. Progression-free survival at 12 months was 47.7% (41.8 to 53.2) with relatlimab-nivolumab as compared with 36.0% (30.5 to 41.6) with nivolumab. Progression-free survival across key subgroups favored relatlimab-nivolumab over nivolumab."

2.  Nivo and Pembro when used as single agents are both known (through data collection over many years) to have an approximate response rate of 40%.  The second article in the link above addressing relatlimab combined with nivo notes (though tallied as PFS):  "Median progression-free survival was 10.1 months in the combination arm and 4.6 months in the monotherapy arm. After 12 months’ follow-up, progression-free survival rates were 47.7% in the combination arm versus 36% in the monotherapy arm..."  The ipi/nivo combo is recognized to have a response rate of 50%+.  The fourth article in this 2021 post - ASCO 2021 - Outcomes of treatments on advanced disease - Reasons for HOPE!!!!! - notes:  "In the phase 3 CheckMate 067 trial, a durable and sustained clinical benefit was achieved with nivolumab (NIVO) + ipilimumab (IPI) and NIVO alone vs IPI at 5-y of follow-up (overall survival [OS] and progression-free survival [PFS] rates: 52%, 44%, 26% and 36%, 29%, 8%, respectively)."  But, we know that PFS and OS is higher earlier on after treatment, so in the first article from this 2017 report - Do melanoma peeps with side effects to immunotherapy have a better response? - it notes:  " The 3-year OS rate of 63% is the highest observed for this patient population and provides additional evidence for the durable clinical activity of immune checkpoint inhibitors in the treatment of advanced melanoma."

3.  Though the combo had greater side effects than when nivo was taken alone - "Grade 3 or 4 treatment-related adverse events occurred in 18.9% of patients in the relatlimab-nivolumab group and in 9.7% of patients in the nivolumab group."  - we know that about 40% of patients on ipi/nivo have to stop the combo due to side effects, with about 55% experiencing grade 3/4 adverse events. 

4.  This post reviewed the Relativity trial of relatlimab and nivo in 2021 - Something "new" in melanoma treatment???? Anti-LAG-3! Again....  Despite the new data and having been reporting on anti-LAG-3 since 2014, I think my summation there still stands:

My take:  It seems that the combination of relatlimab and nivolumab (Opdivo) has a response rate that is slightly less than that of the ipi/nivo (Ipilimumab/Yervoy and Nivolumab/Opdivo) combo which has proven to be around 50+ percent, but one that is possibly better than the 40% response rate when anti-PD-1 (nivo or pembro) is used alone. Perhaps the two most important things these (still preliminary - after all these years) reports tell us is that ~

1.  Side effects, that can be so devastating and difficult in the ipi/nivo combo may be much decreased in the relatlimab/nivo combo.

2.  For reasons we don't fully understand, melanoma responds differently to the same treatment in different folks.  For me, thus far, nivolumab alone was 100% effective.  Obviously that is not the case for most melanoma patients.  So having another effective immunotherapy combination, that may well be far less than 100% effective in all of us, may still be completely effective in some.

And, finally, as ever - the drug company did not see fit to configure the trial such that the new combo went up against the old one directly.  Why not BMS?  Why not????  Why not three arms?  One with nivo alone.  One with the ipi/nivo combo? And the third with relatimab/nivo?  WHY???

5.  We still don't have durability of response data to this combo - but I would presume (given the durability we know about responses to nivo) they would be good.

SOooooooooooooooo - there you have it - a newly FDA approved combo for melanoma dubbed - OPDUALAG!!!!  (Seriously, these names!  My word!)

Now, this:

FDA Approves Relatlimab Plus Nivolumab for Unresectable or Metastatic Melanoma

March 18, 2022  Krista Rosa OncLive

The FDA has approved the fixed-dose combination of relatlimab plus nivolumab (Opdualag) for the treatment of adult and pediatric patients who are 12 years of age or older and who have unresectable or metastatic melanoma.1

The regulatory decision is based on data from the phase 2/3 RELATIVITY-047 trial (NCT03470922), which showed that the doublet (n = 355) resulted in a median progression-free survival (PFS) of 10.1 months vs 4.6 months with single-agent nivolumab (n = 359; P = .0055).

“Since the approval of the first immune checkpoint inhibitor more than 10 years ago, we’ve seen immunotherapy, alone and in combination, revolutionize the treatment of patients with advanced melanoma,” F. Stephen Hodi, MD, director of the Melanoma Center and the Center for Immuno-Oncology at Dana-Farber Cancer Institute, stated in a press release. “Today’s approval is particularly significant, as it introduces an entirely new combination of two immunotherapies that may act together to help improve anti-tumor response by targeting two different immune checkpoints — LAG-3 and PD-1.”

To be eligible for enrollment to RELATIVITY-047, patients had to have previously untreated, unresectable, or metastatic melanoma and an ECOG performance status of 0 or 1.

A total of 714 patients were randomized 1:1 to receive the fixed-dose combination of relatlimab at 160 mg and nivolumab at 480 mg administered every 4 weeks vs single-agent nivolumab at the same dose and schedule.

Patients were stratified by LAG-3 expression on immune cells in the tumor microenvironment, PD-L1 expression on tumor cells, BRAF mutational status, and AJCC v8 M stage.

The primary end point of the trial was PFS per blinded independent central review (BICR). Secondary end points included overall survival (OS) and ORR per BICR. End points were tested in hierarchy, with PFS evaluated first, followed by OS, and then objective response rate (ORR).

Baseline characteristics were well balanced between the arms. The median age of participants was 63 years, 41.7% were female, and 66.9% had an ECOG performance status of 0. The serum lactate dehydrogenase level was above the upper limit of normal in 36.1% of patients.

LAG-3 expression was 1% or higher in 75.2% of patients, and it was lower than 1% in 24.8% of patients. PD-L1 expression was at least 1% in 41.0% of patients, and lower than 1% in 59.0% of patients. Moreover, 38.5% of patients had BRAF-mutated disease, and 61.5% had BRAF wild-type disease. Lastly, 65.7% of patients had AJCC M stage of M0/M1any[0], and 34.3% had M1any[1].

Data presented during the March 2022 ASCO Plenary Series showed that at a median follow-up of 19.3 months, the median OS with the doublet had not yet been reached vs 34.10 months with nivolumab monotherapy.  Although this benefit was not found to be statistically significant, it was considered to be clinically meaningful.

Additional data showed that PFS rates continued to be higher in the doublet arm vs the monotherapy arm. At 12 months, these rates were 48.0%  and 36.9%, respectively; at 24 months, these rates were 38.5% and 29.0%, respectively.

Notably, PFS and OS benefit favored the doublet over the monotherapy across all stratification factors that were assessed.

In the investigative arm, the complete response rate achieved was 16.3%, the partial response rate was 26.8%, and 17.2% of patients experienced stable disease. Additionally, 29.6% of patients in this arm had disease progression.

The median duration of response had not yet been reached in both the relatlimab/nivolumab arm and the control arm. Moreover, the disease control rate achieved with the doublet was 62.8% vs 50.7% with the monotherapy.

Notably, fewer patients who received the doublet went on to receive subsequent therapy vs those who received single-agent nivolumab, at 40.8% and 42.6%, respectively. Specifically, fewer patients in the investigative arm received systemic therapy vs those in the control arm, at 32.7% vs 34.5%, respectively. Additionally, 11.8% of patients who received relatlimab/nivolumab went on to receive PD-L1 and/or CTLA-4 inhibitors vs 15.9% of those who received nivolumab monotherapy.

Specifically, 4.2% of patients on the relatlimab/nivolumab arm went on to recive nivolumab and ipilimumab (Yervoy), 4.2% received nivolumab monotherapy, 3.7% received ipilimumab, 1.7% received pembrolizumab (Keytruda) monotherapy, and no patients received single-agent avelumab (Bavencio); these rates were 6.7%, 5.6%, 5.3%, 2.8%, and 0.3%, respectively.

Additionally, 12.4% of patients on the investigative arm went on to receive BRAF and/or MEK inhibitors vs 14.8% of those on the control arm. Other subsequent treatment was received by 13.8% of those who received the doublet vs 12.3% of those who were given the monotherapy. Slightly more patients on the investigative arm received radiotherapy at 14.6% vs 12.3% on the control arm; however, more patients on the control arm underwent surgery, at 8.1% vs 7.0%, respectively.

The fixed-dose combination is associated with severe and fatal immune-mediated adverse reactions such as pneumonitis, colitis, hepatitis, endocrinopathies, nephritis with renal dysfunction, dermatologic adverse reactions, myocarditis, and other immune-mediated adverse reactions; infusion-related reactions. The doublet is also linked with complications of allogeneic hematopoietic stem cell transplantation and embryo-fetal toxicity.

“While we have made great progress in the treatment of advanced melanoma over the past decade, we are committed to expanding dual immunotherapy treatment options for these patients,” Samit Hirawat, chief medical officer of global drug development at Bristol Myers Squibb, added in the press release. “Inhibiting LAG-3 with relatlimab, in a fixed-dose combination with nivolumab, represents a new treatment approach that builds on our legacy of bringing innovative immunotherapy options to patients. The approval of a new medicine that includes our third distinct checkpoint inhibitor marks an important step forward in giving patients more options beyond monotherapy treatment.”

An updated "Primer of Melanoma Treatments" to be posted soon.  Hang tough, peeps! - c

January and February Reads ~

JANUARY READS:

By mid January Jammer Time was upon us, so some reading time was given over to play and sleep time!  Still, these were my January Reads - 

Sparks Like Stars - Nadia Hashimi.  Hashimi weaves her story out of the 1978 Afghan coup that resulted in the murder of President Daoud, his family, multiple cabinet members and some of their families. Her main character, Sitara, the daughter of a minister to the president, survived the attack on the Presidential Palace, Arg, as a young girl while the rest of her family and best friend did not. Smuggled out of the Palace by a guard, she ends up being adopted by an American Diplomat.  [The woman who becomes her mother, as well as her adopted grandmother are strong, resilient women and probably my favorite characters.]  Now a surgeon, circumstances cause Sitara to examine the past and deal with her present.  I REALLY enjoyed this book!  But, I actually liked the writer's notes in the back most.  Hashimi, now a pediatrician living in Maryland, herself a child of Afghan parents who immigrated to the United States in the early 70's, acknowledged the complicated and difficult relationship that Afghanistan has long had with the United States.  However, she also reported how much her parents appreciated the good hearted, sincere enthusiasm and humor of the American Peace Corps volunteers who taught them English as a second language in the late 60's.  I firmly believe that her parents and my dear B must have crossed paths then - as he was one of those very Peace Corp members in 1969! 

Dracula - Bram Stoker.  While Stoker's novel was based on a nightmare he experienced after over indulging in a crab dinner (so they say) combined with inspiration from European folk tales of the 15th century Romanian Prince, Vlad the Impaler, his is certainly the premier Dracula story.  Sadly, Dracula has become so ubiquitous in stories and film that it is hard to appreciate the original!  I will also confess that vampires and werewolves as a genre are not my cup of tea. However, I read this at Roo's request and it is well written (duh) with more character development than I anticipated.  I can also see where this novel serves as the inspiration for all the vampire tales that have followed. 

FEBRUARY READS:

I was totally spoiled  here.  This month, B read to me!  

From French Stories, Dual Language Edition - as B spruced up his French - we enjoyed:

Micromegas - Voltaire.  EARLY science fiction, published around 1752, tells the story of two huge aliens - one from Saturn and the other from the star Sirius - who travel to and investigate the perplexing residents of Earth.  Very funny and incredibly knowledgeable about science, math, geography, astronomy.  Most impressed.

The Atheist's Mass - Honore de Balzac.  I loved this one!  The story behind why an esteemed surgeon, but acknowledged atheist, attends mass four times a year.  

The Legend of St. Julian the Hospitaler - Gustave Flaubert.  This story was rather horrifying.  Raising every red flag for those trained in evaluating children, Julian spends his childhood and young adult years enjoying the cruel murder of every animal he can find, ending in the destruction of an entire valley of deer and his being cursed by a stag.  He is then haunted by all the animals he destroyed and believe it or not - it just gets worse from there!!!!  OMG!!!

Spleen of Paris (Three Poems in Prose:  The Old Clown, The Poor Boy's Toy, The Rope) - Charles  Baudelaire.  From a sad clown amid the raucous carnival, to a comparison of a wealthy child versus one pitifully poor, to the suicide of a young boy removed from an impoverished family to work in a wealthy man's home and his mother's reaction - while hard to listen to, Baudelaire tells the stories from the light and dark sides of mid-19th century Paris.

Minuet - Guy de  Maupassant. The story of a man looking back on a time in his youth when he came upon an elderly man, dancing as though upon a stage, in a quiet garden. Was pleased to enjoy a new-to-me short story by Maupassant!  

Death of Judas - Paul Claudel.  Written as a monologue by Judas in which he makes the case that he is the most distinguished and deserving of the disciples.  Made me review the Bible's story of Judas.  Can see how Claudel got church leaders jazzed!

The Return of the Prodigal Son - Andre Gide.  Not the biggest fan of Gide after B read us The Immoralist.  Nor have I ever been particularly fond of the story of the prodigal son.  After reading this, it strikes me that perhaps Gide wasn't either.

Grand-Lebrun - Francois Mauriac.  An ode to reading - poetry in particular.

The Passer-Through-Walls - Marcel Ayme.  I LOVED this story.  We laughed aloud - until we got to the end.  For that I am still sad.

Of course all these writers required investigation!  Lots of reading about their lives ensued, revealing a cast of characters their writings scarcely touched!!  Finally, untreated syphilis don't play in the end, y'all!

Read (or listen if you are so blessed) chaotically! ~ les

Springing ??????? forward ~

 With a low of 15 degrees last night and a blazing 29 just now, it doesn't feel very springlike around here!

Poor little daffodils!  Still, we have a warm home, lots of joys and plenty to eat.  No bombs are being dropped on our heads.  We are not required to try to protect our babies in an unheated basement space utilized as a make-do bomb shelter.  We are not forced to flee our homes to seek refuge we know not where in even worse weather conditions.

Perspective is everything.  ~  les

March Forth - for Ukraine

It is with a heavy heart, palpable sadness, and worries that are utterly insignificant to everything the people of Ukraine are experiencing as they are so cruelly attacked by Putin's army, that I dedicate my favorite day - to them.

Today I share the blues and yellows of my world in their honor ~

My dear fellow citizens of this world, dear people of Ukraine, you have demonstrated strength and courage that is awe inspiring.  A spirit that remains a shining light despite the atrocities that you have been dealt and continue to face.  I'm sure it is impossible to feel, but ever so many of us are holding you in our hearts and working to find more tangible ways to give you aid.

Remain strong as you can.  Sending you love and my best hope as I celebrate your beautiful blue and yellow.  March Forth.  ~ les 

Sew Chaotically! ~ Utilitarian Frog Jam Fun!!!

Time watching the Jammer provides perfect moments to plan for the next Jamboree!!!  

First, using bits from my stash, I stitched some quick and dirty burp cloths and hand towels.  So much utilitarian fun!

Digging deeper in my stash, I came across two bibs prepped for a cross stitch design from unknown provenance.  A Jamboree is the perfect time to put them to use!  Not sure if FROG JAM, a yummy preserve made of figs, raspberries, oranges and ginger, is more of a southern thing, but it has always been one of Roo's favs.  Now, it has become a nick name as well as part of a lullaby for a very special little guy.  So it made perfect sense that it become part of many delicious meals to come!

I liked using this type of bib for my little ones, as it provided good coverage and was comfy around chubby necks.  The block colors were a little strange in this one, but my embroidery stash came through.  It was fun designing a bit of cross stitch to work with the colors and the space while incorporating B's favorite bird and a little ditty that Jam loves to 'dance' to ~ 

Can't wait to see these covered in green beans!!!  Live and sew chaotically! ~ les

Relatlimab plus Nivolumab in advanced melanoma patients - better than Nivo (Opdivo) alone!

After the life changing immuno and targeted therapy developments for melanoma patients back in 2011 and a bit beyond, not much new has made our lives substantially better since.  I've been reporting on anti-LAG-3 since 2014.  Anti-LAG-3 reports!  Currently the anti-LAG-3 product Relatlimab is in trials and continues to look promising.  Here are a couple of reports from last year:  Something "new" in melanoma treatment???? Anti-LAG-3! Again...

Now, there's this:

Relatlimab and Nivolumab versus Nivolumab in Untreated Advanced Melanoma.  Tawbi, Schadendorf, Lipson, Ascierto…Hodi, Long.  N Eng J Med.  Jan 2022.

Background: Lymphocyte-activation gene 3 (LAG-3) and programmed death 1 (PD-1) are distinct inhibitory immune checkpoints that contribute to T-cell exhaustion. The combination of relatlimab, a LAG-3-blocking antibody, and nivolumab, a PD-1-blocking antibody, has been shown to be safe and to have antitumor activity in patients with previously treated melanoma, but the safety and activity in patients with previously untreated melanoma need investigation.

Methods: In this phase 2-3, global, double-blind, randomized trial, we evaluated relatlimab and nivolumab as a fixed-dose combination as compared with nivolumab alone when administered intravenously every 4 weeks to patients with previously untreated metastatic or unresectable melanoma. The primary end point was progression-free survival as assessed by blinded independent central review.

Results: The median progression-free survival was 10.1 months (6.4 to 15.7) with relatlimab-nivolumab as compared with 4.6 months (3.4 to 5.6) with nivolumab. Progression-free survival at 12 months was 47.7% (41.8 to 53.2) with relatlimab-nivolumab as compared with 36.0% (30.5 to 41.6) with nivolumab. Progression-free survival across key subgroups favored relatlimab-nivolumab over nivolumab. Grade 3 or 4 treatment-related adverse events occurred in 18.9% of patients in the relatlimab-nivolumab group and in 9.7% of patients in the nivolumab group.

Conclusions: The inhibition of two immune checkpoints, LAG-3 and PD-1, provided a greater benefit with regard to progression-free survival than inhibition of PD-1 alone in patients with previously untreated metastatic or unresectable melanoma. Relatlimab and nivolumab in combination showed no new safety signals.

Relatlimab plus nivolumab improves progression-free survival in metastatic melanoma.  MD Anderson News Release, Jan 5, 2022.

In patients with untreated, advanced melanoma, the combination of immune checkpoint inhibitors relatlimab and nivolumab doubled the progression-free survival benefit compared to nivolumab alone, with a manageable safety profile, according to the results of the Phase II/III  RELATIVITY-047 clinical trial reported by The University of Texas MD Anderson Cancer Center today in the New England Journal of Medicine.

Median progression-free survival was 10.1 months in the combination arm and 4.6 months in the monotherapy arm. After 12 months’ follow-up, progression-free survival rates were 47.7% in the combination arm versus 36% in the monotherapy arm, with a 25% lower risk of disease progression or death in the combination arm. The benefit of the combination therapy was observed across pre-specified subgroups. The Food and Drug Administration granted priority review to the combination in September 2021 based on the results of this study.

“The results from this global effort advance the field of immunotherapy by establishing a third class of immune checkpoint inhibitors through the LAG-3 pathway and have the potential to be practice-changing,” said lead author Hussein Tawbi, M.D., Ph.D., professor of Melanoma Medical Oncology. “We’ve seen historic developments in melanoma treatment over the last decade with the combination of PD-1 and CTLA-4 inhibitors, which work well but also carry substantial toxicity. This study represents a significant and long-awaited next step toward providing patients with effective and safer treatment options.”

Relatlimab is a novel antibody that blocks lymphocyte-activation gene 3 (LAG-3), an immune checkpoint found on the surface of T cells. LAG-3 is often upregulated in melanoma, as is programmed death-1 (PD-1), the immune checkpoint inhibited by nivolumab. These data represent the first Phase II/III clinical trial results of a third-generation checkpoint inhibitor and the first clinical trial designed to compare combination checkpoint inhibitor therapy versus nivolumab monotherapy in melanoma.  

Currently, PD-1 and CTLA-4 inhibitor monotherapy and combination therapy are approved frontline treatment options for metastatic melanoma. The combination therapies benefit more patients than monotherapy, but also greatly affect quality of life, with toxicity rates of more than 50%.

In this study, grade 3 or 4 treatment-related adverse events occurred in 18.9% of patients in the combination arm and 9.7% in the monotherapy arm. The most common grade 3 or 4 events included increased levels of pancreatic and liver enzymes, and fatigue. Investigators determined three deaths in the combination arm and two deaths in the monotherapy arm were treatment-related. Immune-mediated adverse events included hypothyroidism/thyroiditis, rash and colitis. No new safety signals were identified, and patients rated their health-related quality of life similarly across both treatment arms.

The trial enrolled 714 patients with untreated, unresectable stage III or IV melanoma across 111 international sites between May 2018 and December 2020. Patients were randomized to receive relatlimab and nivolumab or nivolumab alone once every four weeks. Sixty patients (8.4%) received prior targeted therapy or immunotherapy as adjuvant therapy at least six months before recurrence, or received interferon six weeks before randomization. The median age of participants was 63; 41.7% were female and 96% were white.

At the time of data cutoff (March 9, 2021), median follow-up was 13.2 months, with 470 patients (65.8%) having discontinued treatment. The top reason for discontinuation was disease progression (36.3% in the combination arm and 46% in the monotherapy arm).

The study met its primary endpoint of blinded independent central review-assessed progression-free survival, with progression defined as tumor growth or death due to any cause. The benefit was sustained across pre-defined subgroups, including BRAF status, tumor stage, lactate dehydrogenase (LDH) levels and LAG-3 and PD-1 expression.

“We now have evidence of a clear benefit for combination therapy compared to single-agent PD-1 inhibitors, and we’re looking forward to seeing response and overall survival data,” Tawbi said. “We’re also thinking about the populations that were excluded from this trial, including those with untreated brain metastases and uveal melanoma, so that all patients can have a chance to take advantage of the progress we’re making against melanoma.”

Hang tough, ratties!  ~ c