Ep 02: RELATIVITY-047

Summary In this episode of Melanoma Matters, James Larkin and Sapna Patel discuss the RELATIVITY 047 trial, which evaluated the combination of nivolumab and relatlimab in frontline metastatic melanoma. They cover the trial design, response rates, overall survival, toxicity, and the role of PD-L1 expression in treatment decisions. They also explore the potential use of nivolumab and relatlimab in patients with brain metastases. While the combination showed a superior progression-free survival compared to nivolumab monotherapy, it did not demonstrate a significant overall survival benefit. The tolerability profile was better than ipilimumab and nivolumab combination therapy but had more side effects than anti-PD-1 monotherapy. Keywords RELATIVITY 047, nivolumab, relatlimab, metastatic melanoma, checkpoint inhibitors, PD-L1 expression, response rates, overall survival, toxicity, brain metastases Takeaways The RELATIVITY 047 trial evaluated the combination of nivolumab and relatlimab in frontline metastatic melanoma. The combination showed a superior progression-free survival compared to nivolumab monotherapy. There was no significant overall survival benefit observed in the trial. The tolerability profile of nivolumab and relatlimab was better than ipilimumab and nivolumab combination therapy but had more side effects than anti-PD-1 monotherapy. PD-L1 expression may play a role in treatment decisions, but its use as a biomarker is still debated. The efficacy of nivolumab and relatlimab in patients with brain metastases is an area of interest. Further follow-up and data analysis are needed to fully understand the long-term outcomes of the combination therapy. Sound Bites "Relativity 047 was a randomized phase three study for frontline metastatic melanoma using dual checkpoint inhibition." "Relativity 047 is hitting some marks, but it's missing others. It has a PFS benefit but no OS benefit." "The CheckMate 067 trial had a sicker population with higher LDH and declining performance status compared to RELA 047." Chapters 00:00 Introduction and Trial Background 04:47 Comparison with CheckMate 067 and Study Population Differences 09:48 Challenges of Using PD-L1 Expression as a Biomarker 24:19 Fact Check: Citations and Clarifications