5 Minutes with Dr Scot Ebbinghaus
5 May 2016
Dr Scot Ebbinghaus (Executive Director of Clinical Research) from Merck Research Laboratories in the US visited our doctors and researchers at MIA last week. We sat down with him to chat about an exciting upcoming clinical trial and where melanoma treatment is headed.
Researchers at MIA have been heavily involved in the clinical trials that led to the approval of Merck’s drug Keytruda (pembrolizumab) as a treatment for advanced melanoma. Where to from here?
We’re starting up a new clinical trial to test Keytruda in combination with a new drug called epacadostat. We’re very excited for this study to be launching in June 2016 and are looking forward to collaborating with MIA to run the trial.
Is epacadostat an immunotherapy, like Keytruda?
Yes, they are both immunotherapies, but epacadostat is a new class of drug called an IDO-1 inhibitor [Keytruda is a PD-1 inhibitor]. IDO-1 is expressed by many melanoma tumours. When it is expressed in melanoma tumours it can dampen the immune response to melanoma. We think that it will have a high level of activity in melanoma when we combine it with Keytruda. Immunotherapies are designed to enhance the body’s own defences in fighting cancer; the two therapies target distinct regulatory components of the immune system.
What is this combination likely to achieve?
Preliminary data suggests that the combination of these two drugs may lead to an enhanced anti-tumour immune response compared with either drug alone.
We hope this combination will result in a larger fraction of advanced melanoma patients responding to treatment. With Keytruda, we expect to see 30%–40% of patients having a beneficial response as a monotherapy; with this new combination therapy, we hope to see 50%–60% of patients having a beneficial response.
Combination drug therapy often leads to greater side effects for patients. Is that expected here?
The importance of this trial is that in addition to increasing the activity of Keytruda and hopefully reaching more patients, it’s relatively modest on the toxicity side. There are other immunotherapy combinations that are under development but one of the major drawbacks is that there are a lot of toxicities. Our preliminary data with this combination suggests that it’s very well tolerated and so we’re going to be confirming that in this large phase 3 international trial.
With extensive experience in oncology in the medical world, academia and pharmaceutical industry, what is the future of melanoma looking like from your perspective?
The future of melanoma is quite bright. We’ve opened the door to a new era of treating melanoma. The goal of the next 5–10 years is to further improve on the door that we’ve opened. My message to melanoma patients from the perspective of someone who develops new drugs for melanoma in a company is that we’re investing a lot of time, energy and money into making new medicines for melanoma. We think there is a lot of hope and promise for further therapeutic advances in melanoma, and that is very exciting.