Comparing nivolumab and ipilimumab treatment after surgery for advanced melanoma

This study compared nivolumab (Opdivo) and ipilimumab (Yervoy) for treating advanced melanoma that has been surgically removed. They found that patients treated with nivolumab survived cancer-free for longer than patients treated with ipilimumab.

Melanoma which has spread to the lymph nodes or other organs is usually treated first with surgery. After surgery other treatments are often used to reduce the risk of recurrence. One of these treatments involves immune therapy with one of two drugs, nivolumab or ipilimumab. These drugs activate the immune system to detect and kill any cancer cells left after surgery. It is not yet known which of these drugs is the safest and most effective in patients with advanced melanoma that has been surgically removed.

906 patients with melanoma participated in this study. All participants had melanoma which had spread either to lymph nodes or to other organs and had already been treated with surgery. Participants were divided into 2 groups. 453 people were treated with nivolumab and 453 people were treated with ipilimumab. Participants were followed up for an average of 50.9-51.1 months to monitor for the recurrence of melanoma.

Of the group receiving nivolumab, 51.7% remained cancer-free at 4 years, compared to 41.2% of the ipilimumab group. On average patients treated with nivolumab remained cancer-free for 52.4 months compared to 24.1 months in the group treated with ipilimumab. Overall, at 4 years 77.9% of the nivolumab group and 76.6% of the ipilimumab group were still alive.

Complications due to treatment occurred in 4% of the nivolumab group and 6% of the ipilimumab group. Serious complications occurred in 1% of the nivolumab group and 2% of the ipilimumab group. There were 2 treatment-related deaths in the ipilimumab group and none in the nivolumab group.

This study showed that patients with advanced melanoma that was surgically removed treated with nivolumab remained cancer-free for longer compared to patients treated with ipilimumab.  

This study was funded by Bristol Myers Squibb, the manufacturer of both nivolumab and ipilimumab.