Oncology changes quickly. The melanoma treatment updates 2025 from the ASCO Annual Meeting offer vital help. Dr. Gino K. In, MD, MPH, from USC Norris Comprehensive Cancer Center, shared insights. His talk happened at the MOASC Spotlight 2025 in Newport Beach, CA. It covered therapy sequencing for BRAF V600-mutant melanoma. He also discussed Lifileucel and adjuvant PD-1 for high-risk CSCC. These updates show strong, immunotherapy-led plans. They boost survival and life quality.
The findings come from trials like DREAMSeq, C-144-01, and C-POST. Dr. Inโs presentation can change practice. It aids healthcare workers and patients. Therefore, these updates bring hope and clear direction.
Why Start with Immunotherapy Before Targeted Therapy in BRAF-Mutant Melanoma?
Since 2015, two solid options shaped melanoma treatment updates 2025. Immunotherapy uses PD-1/CTLA-4 (e.g., nivolumab + ipilimumab). Targeted therapy uses BRAF/MEK inhibitors. Immunotherapy has 50-60% response rates. It offers lasting results, with 50% 10-year survival from CheckMate 067. However, targeted therapy hits 70-80% but fades in 1-2 years.
The DREAMSeq trial (ECOG-ACRIN EA6134) settled sequencing. It studied 265 BRAF V600-mutant patients. Arm A started with immunotherapy. It included nivolumab/ipilimumab induction. Then, nivolumab maintenance followed. Arm B began with targeted therapy. It involved dabrafenib/trametinib continuously. Crossover occurred at progression.
At 2 years, 68.3% survived with immunotherapy. Only 54.1% did with targeted therapy (p<0.01). Five-year data improved this. It showed 53% versus 33% OS. The gap was 29.4%.
“So we really think that when it comes to survival, using immunotherapy first is the preferred option.” โ Dr. Gino K. In
PFS favored immunotherapy too. It reached 26.7 months versus 8.5 months. Responses were deeper and longer. However, symptomatic patients (e.g., visceral crisis) may start with targeted therapy. Then, they switch back.
This melanoma treatment updates 2025 takeaway from MOASC Spotlight 2025 is clear. Prioritize immunotherapy. Save targeted options for later use.
Lifileucel: A Game-Changer for Advanced Melanoma After Treatment Failure
For patients failing immunotherapy and targeted therapy, melanoma treatment updates 2025 highlight Lifileucel. This FDA-approved TIL therapy began in March 2024. Itโs a one-time treatment. It takes tumor-infiltrating lymphocytes from a metastasis. The lab grows them. Then, reinfusion happens after lymphodepleting chemo. This releases tailored immune attacks.
The C-144-01 trial tested heavily pretreated patients. They had a median of 3 prior lines. Results showed a 31% response rate. One-third responded despite setbacks. Median OS was 13.9 months. Five-year OS reached 19.7%. Durability stood out. Responses grew over time. For example, 4 patients went from partial to complete at 3 years. Some lasted 58.7 months.
“Even patients who’ve had almost every other available melanoma therapy and not respond to those therapies, up to a third of those will respond to TIL therapy or Lifileucel.” โ Dr. Gino K. In
No new side effects appeared. This makes it rewarding for risky cases. Dr. In noted at MOASC Spotlight 2025, itโs “exciting times” for tough melanoma.
Adjuvant PD-1 Therapy: Preventing Recurrence in High-Risk Skin Cancer
High-risk CSCC often returns. Surgery, radiation, and cisplatin fail to stop it. Melanoma treatment updates 2025 cover non-melanoma cancers too. The C-POST Phase 3 trial tested this. It used adjuvant cemiplimab (PD-1 inhibitor). This was after surgery/radiotherapy. It involved 417 high-risk patients. Examples include nodal issues and perineural invasion.
Results showed a disease-free survival hazard ratio of 0.31. This cut risk by 69% (95% CI 0.20-0.47, p<0.0001). Strong responses in metastatic cases helped. They now prevent recurrence.
“There was a clear benefit with a hazard ratio of 0.31, clearly favoring the role of adjuvant PD-1.” โ Dr. Gino K. In
This suits repeated cases. It could avoid endless treatments. This was a key point from MOASC Spotlight 2025.
Key Takeaways: Implementing 2025 ASCO Melanoma Updates from MOASC Spotlight 2025
- BRAF V600 Melanoma: Use immunotherapy first. Targeted therapy is for salvage. This lifts survival.
- Post-Progression: Lifileucel gives lasting responses. It helps 31% of tough patients.
- High-Risk CSCC: Adjuvant PD-1 raises disease-free survival by 69%.
These melanoma treatment updates 2025 from Dr. In, presented at MOASC Spotlight 2025 in Newport Beach, CA, focus on patient care.