In a nutshell
The authors reviewed different immunotherapies for advanced melanoma.
Some background
In advanced melanoma (stage III/IV), cancer spreads from the skin to other parts of the body. Immunotherapy is a common treatment used in advanced melanoma. It uses the body’s own immune system to fight cancer. This therapy works by blocking important proteins (e.g. PD-1, CTLA-4). This blocking triggers the immune system to attack tumor cells. Ipilimumab (Yervoy) is an example of this treatment. It has shown considerable survival benefits in advanced melanoma. However, many melanoma patients become resistant to this drug during the course of treatment.
Therefore, an understanding of alternate immunotherapies will help patients to decide on appropriate treatments.
Methods & findings
The authors compared the effectiveness of different immunotherapies for the treatment of advanced melanoma.
The effect of nivolumab (Opdivo) was compared with standard chemotherapy drug dacarbazine (DTIC) in a phase III trial. 418 patients were included in this study. The 1-year survival rate was 73% for patients treated with nivolumab. It was 42% for patients treated with dacarbazine. In another phase III trial, patients were treated with either nivolumab or chemotherapy. These patients had previously experienced disease progression after treatment with ipilimumab. The overall response rate (partial or complete disappearance of tumors after treatment) was 11% with chemotherapy. It was 32% with nivolumab.
In a phase II trial, the effectiveness of pembrolizumab (Keytruda) was compared with standard chemotherapy. The patients in this trial were resistant to ipilimumab. Progression free survival (patients who did not experience cancer growth after treatment), response rate and overall well–being were significantly better in patients treated with pembrolizumab compared to chemotherapy.
In a phase I study, the effectiveness of combination treatment with different immunotherapies was evaluated. The drugs used were ipilimumab and nivolumab. The overall response rate was 40% for patients treated with combination treatment. This was significantly higher than that obtained from single treatment by either drug. However, 53% of patients treated with combination treatment had severe or life threatening side effects.
The bottom line
The authors concluded that immunotherapies were superior to standard chemotherapy treatments in advanced melanoma.
Published By :
British Journal of Cancer
Date :
Apr 09, 2015
