The Combination of Anti-PD-1 With Radiotherapy in Previously Untreated Metastatic Melanoma
Status:
Recruiting
Trial end date:
2022-07-01
Target enrollment:
Participant gender:
Summary
Currently, the first line treatment options for surgically unresectable metastatic melanoma
includes anti-PD1 agents such as nivolumab and pembrolizumab. In western countries, UV
associated cutaneous melanoma has 30-40% response rates to immune checkpoint inhibitors
(ICIs). However, response rates are lower in Asians. The reason for this discrepancy is
attributed to the difference in subtypes since most of the Asian patients are mostly
subgrouped as acral lentiginous or mucosal types that are unrelated to UV exposures. Thus,
there is an unmet need to bolster the effect of ICIs in these patients.
The combination of radiotherapy with ICIs have been demonstrated by several pre-clinical
studies. High dose radiation has shown to promote STING pathway which activates dendritic
cells needed in priming phase. In addition, low dose radiation may activate macrophage
differentiation. These mechanisms in turn may enhance responses to immunotherapy.
In this study, the investigators aim to evaluate the efficacy and tolerability of anti-PD-1
blockade in combination with radiotherapy in surgically unresectable, treatment naive
metastatic melanoma.