In a nutshell
This study investigated the effect of nivolumab (Opdivo) in patients with progressive melanoma after ipilimumab (Yervoy) treatment. Researchers suggested that nivolumab treatment is associated with better response compared with chemotherapy.
Recent new therapies, such as immunotherapy, have changed the treatment of advanced melanoma. Immunotherapies help the immune system to attack and kill cancer cells. Ipilimumab was the first treatment to increase survival in metastatic (spread to other parts of the body) melanoma patients. However, more than one half of the patients progress on this treatment. Treatment with nivolumab has also been shown to increase tumor response in advanced melanoma. However, the effects of nivolumb in patients who have progressed after treatment with ipilimumab are not clear.
Methods & findings
The objective of this study was to investigate the effects of nivolumab in the treatment of advanced melanoma that progressed after treatment with ipilimumab.
This study included 370 patients with advanced melanoma. These patients were randomly assigned to receive nivolumab (268 patients) or chemotherapy (102 patients). The average duration of therapy was 4.7 months for nivolumab and 2 months for chemotherapy. The average follow-up time was 2 years.
The overall response rate was higher for nivolumab (27%) when compared to chemotherapy (10%). The average length of response was 32 months for those treated with nivolumab. This was significantly longer compared to chemotherapy (13 months).
Average overall survival (time from treatment until death from any cause) and time to disease progression were not significantly different.
There were fewer side effects associated with nivolumab (14%) when compared to chemotherapy (34%). These side effects were manageable.
The bottom line
This study suggested that treatment with nivolumab after failed treatment with ipilimumab is associated with better overall survival and tumor response.
Published By :
Journal of clinical oncology
Jul 03, 2017