Do melanoma patients who stop nivolumab and ipilimumab treatment still benefit from it?

This study analyzed outcomes in advanced skin cancer patients who stopped their treatment of nivolumab (Opdivo) and ipilimumab (Yervoy) due to side effects. This study concluded that many patients still benefit from the combination even after stopping treatment. 

Nivolumab and ipilumamab are commonly used targeted therapies for effective treatment of advanced melanoma. These treatments target certain proteins involved in cancer growth. However, there may be high rates of side effects with this treatment. These include colitis (inflammation of the intestines), diarrhea, and liver damage. Some patients may need to stop treatment due to these side effects. It is not clear whether these patients see a benefit from what treatment they received.  

407 melanoma patients were given the combination therapy of nivolumab plus ipilimumab. 176 (43%) stopped treatment because of side effects. 96 of these (24%) stopped during the initial stages of treatment. The remaining 231 included patients who discontinued for other reasons, such as disease progression.

58% of patients who stopped in the beginning (induction phase) due to side effects showed a response to treatment. 50.2% of patients who stopped treatment for other reasons showed a response. Average time to disease progression was 8.4 months for patients who stopped due to side effects, and 10.8 months for patients who did not.

The study concluded that treatment effectiveness was similar between the two groups. The authors suggested that many melanoma patients may still benefit from the combination therapy of nivolumab plus ipilimumab even after stopping treatment.

Further research is required to see if patients who stop treatment may benefit from a different type of therapy with less side effects. The time taken to best respond to treatment before stopping, should also be studied. Better understanding of the side effects may also be beneficial.

Discuss with your doctor the pros and cons of beginning the combination therapy of nivolumab + ipilimumab.