What Is the Best Immunotherapy Treatment Duration for Advanced Melanoma?

One year of immunotherapy is optimal for treating patients with advanced melanoma, according to a study presented at the 2024 American Society of Clinical Oncology Annual Meeting.

According to the investigators, the optimal duration of anti-PD-1 therapy for metastatic melanoma remains unestablished. This study sought to evaluate the optimal duration of immune checkpoint inhibitors (ICI).

Researchers conducted emulated trials using the cloning, weighting, and censoring approach. Each trial, they noted, aimed to compare the causal effect of stopping versus continuing ICI at a specific time point. They analyzed a total of 1017 patients from the MELBASE cohort.

According to results of the 6-month discontinuation-emulated trial, there was a notably lower overall survival if immunotherapy was discontinued compared with continuing treatment for at least 3 months. The 48-month survival difference was 37.8% (95% CI, 19.8-60.5), and the corresponding restricted mean survival time difference was 8.3 months (95% CI, 4.1-12.7). Researchers noted that both the 12- and 18-month discontinuation-emulated trials showed no evidence of benefit of either discontinuing or continuing ICI at any of those time points.

Overall, results showed that the 24-month discontinuation-emulated trial results were more in favor of stopping compared with continuing treatment at that decision point.

“These results suggest that a 1-year course of immunotherapy is both necessary and sufficient for patients with advanced melanoma. Prolonged treatment beyond 2 years does not appear to be beneficial in terms of survival and could even be detrimental,” the researchers concluded.

Reference

Huang Y, Yoh K, Szarmreta E, Xu X, Hershman D, Wright JD. Patterns of pembrolizumab use for recurrent cervical cancer. Abstract #e17528. Published for the 2024 American Society of Clinical Oncology Annual Meeting; May 31-June 4, 2024; Chicago, Illinois.