Melanoma: dual neoadjuvant checkpoint blockade feasible

  • Amaria RN & al.
  • Nat Med
  • 8 oct. 2018

  • de Brian Richardson, PhD
  • Univadis Clinical Summaries
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Results from a phase 2 study suggest that nivolumab monotherapy and combined nivolumab/ipilimumab are feasible neoadjuvant therapies for patients with high-risk resectable melanoma.

Why this matters

  • This phase 2 trial supports the feasibility of neoadjuvant immune checkpoint blockers but raises toxicity concerns for combined ipilimumab/nivolumab and suggests a need for further studies.

Key results

  • Combined ipilimumab/nivolumab with associated with a higher RECIST overall response rate (73% vs 25%) and pathologic complete response rate (45% vs 25%) but also a higher rate of grade 3 treatment-related adverse events (73% vs 8%) compared with nivolumab monotherapy.
  • Combined ipilimumab/nivolumab was associated with significantly improved radiologic outcomes (P=.039) but similar PFS (82% at 17.2 months vs 58% at 22.6 months; P=.19) and OS (100% at 24.4 months vs 76% at 22.6 months; P=.18) compared with nivolumab alone.

Study design

  • 23 patients with high-risk resectable melanoma, 12 who received nivolumab monotherapy and 11 who received combined ipilimumab and nivolumab, were analyzed.
  • Funding: Bristol-Myers Squibb; University of Texas MD Anderson Cancer Center Melanoma Moon Shot Program; Parker Institute for Cancer Immunotherapy; US Department of Defense.

Limitations

  • Small patient sample size.