ASCO Annual Meeting
May 31, 2015
Recently, researchers found that nivolumab (Opdivo) either given as a single treatment or in combination with ipilimumab (Yervoy) is more effective than treatment with ipilimumab alone for people with advanced melanoma. Both nivolumab and ipilimumab are types of immunotherapy that block two proteins called PD-1 and CTLA-4. By blocking these two proteins, the drugs are able to boost the body’s immune system to fight the cancer.
The PD-1 protein on the body’s immune cells attaches to another protein called PD-L1, which is found on the surface of some cancer cells. Previous research has suggested that PD-1 therapy works better for patients who have PD-L1 on the tumor cells.
For this study, 945 patients who had not yet received treatment for advanced melanoma were given either ipilimumab, nivolumab, or a combination of both. The researchers found that nivolumab controlled the growth of the melanoma for more than twice as long as ipilimumab (about 7 months compared with about 3 months). The combination of nivolumab and ipilimumab controlled the cancer’s growth for longer, about 12 months.
Researchers also found that nivolumab by itself seemed to work as well for cancer with PD-L1 as nivolumab and ipilimumab combined. However, for patients with cancer without PD-L1, the combination of nivolumab and ipilimumab worked better than just nivolumab.
What this means for patients
“Our study also suggests that patients with a specific tumor marker appear to benefit the most from the combination treatment, whereas other patients may do just as well with nivolumab alone. This will help doctors provide important insight for patients on which treatment is right for them,” said lead study author Jedd Wolchok, MD, PhD, Chief of Melanoma and Immunotherapeutics Service at Memorial Sloan Kettering Cancer Center in New York, NY.
In this study, about one-third of patients taking the combination of nivolumab and ipilimumab needed to stop treatment because of the side effects. However, for patients that can continue treatment, previous research has shown that the benefits of immunotherapy continue even after the drug is stopped.
Ipilimumab and nivolumab are both approved by the U.S. Food and Drug Administration (FDA) for melanoma that cannot be removed with surgery and advanced melanoma when other treatments stop working. Talk with your doctor about your treatment options, the risks and benefits of these options, as well as other concerns about managing your care.
Questions to ask your doctor
- What stage of melanoma do I have? What does this mean?
- What are my treatment options?
- What clinical trials are open to me?
- Was my tumor tested to learn more about my treatment options?
- What are the possible side effects of each treatment option? How can they be managed?