Pembro plus Epacadostat

[Anonymous]

What are your thoughts on the Phase III trial with pembro plus Epacadostat not reaching its endpoint? I feel like we had a lot of patients that did quite well on it, though I suppose those might be the patients that would have responded just as well to single agent PD-1. Have you all had a lot of questions about this trial from patients?

[Anonymous]

Surprisingly, we have not had many patients asking us about this trial. I know going into it there was a lot of excitement about the combination so we were surprised it did not reach its endpoint.

[Anonymous]

Yeah…..I guess we still had patients on it in the phase 1 setting that were eager. They’ve obviously done well if still on it in Phase 1, but I think some of them were hoping it would be approved so they could get through local oncologist.

[Anonymous]

The results of this trial were quite striking, especially with strong Phase I/II data. There is some thought that the dose of the IDO inhibitor may have been too low. Was very disappointing as this may have been a good alternative to dual ICI therapy in those that tolerability was questionable.

[Anonymous]

We have been spoiled lately; in that so many treatment options for melanoma have become available in the recent years. We have not been disappointed by trial results in quite a while (thankfully). Perhaps this is a reminder to all of us that indeed, melanoma remains a difficult to treat malignancy.

[Anonymous]

So true! We have been SO fortunate to have gained such ground in melanoma over the last several years!

[Anonymous]

We’re now having to notify patients that the trial didn’t reach its endpoint and take them off the IDO. This is really tough for those patients that have been on this in Phase 1 for quite some time……especially considering that some did REALLY WELL!

[Samantha Guild]

We were just discussing this last week. After years of ASCO having huge announcements of positive very influential findings things have slowed down. With the discovery of Ipilimumab and Nivolumab and the BRAF/MEK inhibitors we are almost at a plateau when it comes to new innovations. I am sure there are many more to come but at the moment especially front line clinical trials seems to be limited.

[Anonymous]

Rajni–
such a good point.
In the melanoma world, we have been lulled into this sense that every year there will be new treatments for melanoma. The last five years have been amazing, with so many new therapies and new combinations of therapies that have truly changed the way we manage melanoma. This year was the first in which it seemed like it slowed down.

[Author]

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