Combining Immunotherapy and Targeted Therapy to Treat Melanoma

The FDA has approved a combination of the immune checkpoint inhibitor atezolizumab with two targeted therapies for certain patients with advanced melanoma. 

The U.S. Food and Drug Administration (FDA) has approved an immunotherapeutic to be used in combination with two targeted therapy agents to treat certain patients with unresectable or metastatic melanoma.

Atezolizumab (Tecentriq) is an immune checkpoint inhibitor that blocks proteins that normally suppress the body’s immune response to attack cancer. It has been approved in combination with two targeted therapeutics, vemurafenib (Zelboraf) and cobimetinib (Cotellic).

The combination regimen is intended to treat patients whose melanoma tumors have BRAF V600 mutations. Roughly 50 percent of melanomas are fueled by genetic changes in the BRAF gene. Vemurafenib inhibits the function of an altered protein made by the gene while cobimetinib targets another related protein. The two drugs have been found to be more effective when given together. 

The efficacy of this new drug trio was demonstrated in a double-blind, randomized, placebo-controlled, multicenter trial involving 514 patients. The median progression-free survival (PFS) in patients who received all three therapeutics was 15.1 months, compared with 10.6 months for those in the control group who received the combination of vemurafenib and cobimetinib without atezolizumab.

Melanoma is a type of skin cancer that develops when the cells that give the skin its tan or brown color grow out of control. While melanomas can develop anywhere on the skin, they are more likely found on the trunk, face, or neck. In 2020, more than 100,000 people in the United States are expected to be diagnosed with melanoma and some 6,850 are expected to die of the disease, according to federal statistics. 

The FDA approval was rendered on July 30, 2020.