Melanoma Survival Rates with PD-1 Inhibitor Treatment Examined in Recent Study

The overall survival rate of patients with advanced melanoma that progressed after treatment with ipilimumab who received nivolumab was similar to the overall survival rate of patients who received chemotherapy, according to the findings of a recent study.

The study included 272 patients with advanced melanoma who were randomly assigned to receive 3 mg/kg intravenous nivolumab every 2 weeks, and 133 patients who were randomly assigned to receive an investigator’s choice of chemotherapy (ICC) until they experienced disease progression or unacceptable toxicity. Patients were stratified by programmed death-ligand 1 expression, use of BRAF inhibitor, and best prior cytotoxic T-lymphocyte antigen-4 therapy response, and followed for approximately 2 years.
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At baseline, more patients who received nivolumab had brain metastases compared with those who received ICC (20% vs 14%), as well as increased lactate dehydrogenase levels (52% vs 38%). Anti-programmed death 1 agents were given to 41% of patients treated with ICC compared with 11% of patients treated with nivolumab after patients were assigned to therapy arms.

The median overall survival for patients treated with nivolumab was 16 months compared to the median overall survival of 14 months for patients treated with ICC. Nivolumab treatment was associated with a median progression-free survival of 3.1 months compared with the median progression free survival of 3.7 months associated with ICC treatment. Additionally, nivolumab treatment was associated with higher overall response rate and median duration of response compared with ICC treatment (27% vs 20%, and 32 months vs 13 months, respectively).

In addition, patients who received nivolumab had fewer grade 3 and 4 treatment-related adverse events compared with patients who received ICC (14% vs 34%).

“Nivolumab demonstrated higher, more durable responses but no difference in survival compared with ICC,” the researchers concluded. “[Overall survival] should be interpreted with caution as it was likely impacted by an increased dropout rate before treatment, which led to crossover therapy in the ICC group, and by an increased proportion of patients in the nivolumab group with poor prognostic factors.”

—Melissa Weiss

Reference:

Larkin J, Minor D, D’Angelo S, et al. Overall survival in patients with advanced melanoma who received nivolumab versus investigator’s choice chemotherapy in CheckMate 037: A randomized, controlled, open-label phase III trial [published before print July 3, 2017]. J Clin Oncol. doi:10.1200/JCO.2016.71.8023.