Pembrolizumab or ipilimumab in treatment of advanced melanoma

This study looked at the safety and effectiveness of pembrolizumab (Keytruda) and ipilimumab (Yervoy), in the treatment of patients with advanced melanoma. The authors found that overall survival was higher in the group treated with pembrolizumab in all cases.

Cancer cells can have different receptors for certain compounds on their surface. These receptors can be used to target cancer cells in treatment. The PD-L1 receptor is an important receptor found on some melanoma cancer cells. By using medications which activate this receptor, cancer cells can be killed without harming normal cells.

This study consisted of 833 patients with advanced melanoma cancer. All tumors were tested for presence of the PD-L1 receptor. Patients received one of three treatments. Patients either received pembrolizumab every two weeks, pembrolizumab every three weeks, or ipilimumab every three weeks. Patients were followed for 34 months on average. Of the patients, 66% had never received a treatment for melanoma before. It was noted that 83% of patients had tumors positive for the PD-L1 receptor.

The authors concluded that in the patients treated with pembrolizumab, 33.2% survived for over 24 months after treatment. In the patients treated with ipilimumab, 13.1% survived for over 24 months after treatment. Patients who were positive for the receptor PD-L1 survived two times longer when treated with pembrolizumab. Average survival without growth of the tumor was 6.6 months in patients treated with pembrolizumab and 2.8 months in patients treated with ipilimumab.

The study concluded that pembrolizumab is a better medication than ipilimumab in treating patients with advanced melanoma.

This study is not large, with only 833 patients. A larger study may give more specific information. Over 80% of patients in this study had PD-L1 receptor positive cancers. Pembrolizumab is specifically made to target the PD-L1 receptor. This may have had some influence on the results.

Discuss your treatment plan with your oncologist.