In a nutshell
This study looked at two medications for treatment of melanoma, nivolumab (Opdivo) and ipilimumab (Yervoy), and analysed how well they worked in patients who have melanoma which has spread to the brain. The study found that the combination of nivolumab and ipilimumab had significant clinical benefit in patients with melanoma with brain metastases.
Melanoma cancer has the ability to spread to the brain and cause significant issues if left untreated. Many studies have looked at nivolumab and ipilimumab in treatment of melanoma. However, the effect of these medications on metastases in the brain have not been performed.
Methods & findings
This study consisted of 94 patients with melanoma which had spread to the brain. None of these patients had had any previous treatment for the tumors in the brain. Each patient was treated with nivolumab and ipilimumab every three weeks for four doses, plus additional nivolumab every two weeks, up to a maximum of 24 months. Six months after treatment, patients were assessed and classed into categories depending on how the tumors responded. Patients either had progression of disease, stable disease, partial response, or complete response.
It was found that 57% of patients had achieved a stable disease status, where there was no additional tumor growth at a minimum. There were 26% of patients that achieved a complete response where the tumor had completely disappeared. There were 30% of patients who had a partial response. It was noted that during the trial, 20% of patients stopped treatment due to side effects. They found that 55% of patients noted some sort of adverse effect of the treatment. The most common side effect was headaches.
The bottom line
The study concluded that nivolumab and ipilimumab were effective medications in treatment of melanoma that had spread to the brain.
The fine print
This study is not large, with only 94 patients. The high drop-out rate due to side effects is a potential downside of this treatment.
Patients with brain metastases may wish to discuss their treatment plan with their oncologist in light of these findings.
Published By :
The New England Journal of Medicine
Aug 23, 2018