Nivolumab Monotherapy or With Ipilimumab Effective for Melanoma Patients

A recent study compared long-term overall survival rates at five years in patients with advanced melanoma who were treated with nivolumab or ipilimumab monotherapy or a combination of the two. The authors here concluded that overall survival was greater in patients who received nivolumab alone or in combination compared to standalone ipilimumab.

“Nivolumab plus ipilimumab or nivolumab alone resulted in longer progression-free and overall survival than ipilimumab alone in a trial involving patients with advanced melanoma. We now report 5-year outcomes in the trial,” stated the authors, whose study was published in the New England Journal of Medicine.

Patients with previously untreated advanced melanoma were randomized to nivolumab (1 mg/kg of body weight) plus ipilimumab (3 mg/kg) every three weeks for four doses, followed by nivolumab (3 mg/kg every two weeks); nivolumab (3 mg/kg every two weeks) plus ipilimumab-matched placebo; or ipilimumab (3 mg/kg every three weeks for four doses) plus nivolumab-matched placebo. The primary outcome measures were progression-free survival and overall survival (OS) in the combination and nivolumab monotherapy groups compared to the ipilimumab alone group. Patients were followed for at least 60 months.

Melanoma Improves with Nivolumab Combo or Monotherapy

At final follow-up, the median OS was more than 60 months in the nivolumab plus ipilimumab group and 36.9 months in the nivolumab group, versus 19.9 months in the ipilimumab alone group. The hazard ratios for death, as compared with the ipilimumab group, were 0.52 with combination nivolumab plus ipilimumab treatment and 0.63 with nivolumab monotherapy. Five-year OS was 52% in the nivolumab plus ipilimumab group, 44% in the nivolumab group, and 26% in the ipilimumab group. No patients treated with nivolumab plus ipilimumab or nivolumab alone experienced deterioration of health-related quality of life during or after treatment, and no new late toxic effects were recorded.

“Among patients with advanced melanoma, sustained long-term overall survival at 5 years was observed in a greater percentage of patients who received nivolumab plus ipilimumab or nivolumab alone than in those who received ipilimumab alone, with no apparent loss of quality of life in the patients who received regimens containing nivolumab,” the researchers wrote in summary.