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Closing in on a Cure for Advanced Melanoma?
Historically, aiming for a cure in patients with stage IV melanoma has seemed an unrealistic goal or sometimes a lucky exception. In an international, industry-sponsored, phase 3 study, researchers previously reported better survival outcomes for patients who received nivolumab-containing immunotherapy regimens after 3 years of follow-up (N Engl J Med 2017; 377:1345) and after 6.5 years (J Clin Oncol 2022; 20:127) compared with ipilimumab monotherapy. Now, with a minimum follow-up of 10 years, they report the final analysis of the outcome.
Median overall survival at 10 years was significantly longer in the nivolumab-ipilimumab and nivolumab arms than in the ipilimumab arm (71.9 and 36.9 vs. 19.9 months). Among patients who were alive and without disease progression at 3 years, 10-year melanoma-specific survival was 97% in the nivolumab group, 88% in the ipilimumab group, and 96% in the nivolumab-ipilimumab group. No new safety signals were noted.
Comment
While we may still be judicious with the word “cure,” the 10-year melanoma-specific survival rate in the two nivolumab groups is astounding and suggests that patients who have received immunotherapy are living long enough to put them at competing risk for non-melanoma deaths. For my patients with metastatic melanoma who are alive and well in their third year after starting immune checkpoint treatment, I'll be happy to encourage them to watch their cholesterol, get some exercise, and plan for a long and healthy future. That should be the rule and not the exception.
Citation(s)
Author:
Wolchok JD et al.
Title:
Final, 10-year outcomes with nivolumab plus ipilimumab in advanced melanoma.
Source:
N Engl J Med
2024
Sep
15; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Margaret Callahan, MD, PhD