Ep 20: Neoadjuvant Nivolumab + Relatlimab

SummaryWhat is the plural of myocarditis? Prof Larkin claims it is myocarditities. In this episode of Melanoma Matters, James Larkin and Sapna Patel discuss the recent study on neoadjuvant therapy using Nivolumab and Relatlimab for melanoma treatment. They explore the study's design, results, and implications for future therapies, particularly focusing on the high rate of complete pathological responses observed. The conversation also delves into the toxicity associated with these treatments, particularly myocarditis, and the need for careful monitoring and understanding of these side effects. They conclude by discussing the future of NivoRela in the neoadjuvant space and the importance of ongoing research and clinical trials.KeywordsNeoadjuvant therapy, NivoRela, melanoma, myocarditis, immunotherapy, toxicity, clinical trials, cancer treatment, PD-1 blockade, LAG-3 blockadeTakeawaysThe study involved 30 patients, with 29 undergoing surgery.57% of patients achieved a complete pathological response.Myocarditis is a significant concern with LAG-3 blockade.NivoRela appears to have less toxicity than full-dose Nivo Ipi.The need for randomized trials to establish efficacy is critical.Correlatives in the study showed dynamic markers post-treatment.Myocarditis can be subtle and difficult to diagnose clinically.Troponin levels are not definitive for diagnosing myocarditis.The regulatory framework can complicate the implementation of new therapies.The conversation emphasizes the importance of ongoing research in melanoma treatment.Sound Bites"This is really just such a nice commentary.""57% complete pathological response."Chapters00:00 Introduction and Quick Fire Question01:58 Overview of the Study05:26 Discussion on Myocarditis07:41 Comparison of NivoRela Toxicities13:53 Correlatives and Diagnostic Criteria for Myocarditis