Ipilimumab alone on par with combination therapy in advanced melanoma

Survival in patients treated with ipilimumab monotherapy is comparable to those who received ipilimumab in combination with anti-PD-1 antibodies, a study has shown.

The investigators retrospectively compared the overall survival of patients who lost response to anti-PD1 antibodies between those treated with single-agent ipilimumab or ipilimumab and nivolumab. They reviewed a de-identified US nationwide electronic health record-derived database for patients with advanced melanoma treated with single-agent anti-PD-1 antibodies in the frontline setting and who subsequently received second-line ipilimumab or combination ipilimumab and nivolumab.

The investigators then compared overall survival from initiation of second-line therapy using Kaplan Meier curves and log-rank analysis and analysed other known prognostic markers for melanoma for correlation with survival in a similar fashion. Finally, they compared disease characteristics between the two groups using chi-square analysis.

The analysis included 842 patients with advanced melanoma treated with frontline anti-PD-1 antibodies, of whom 57 received either ipilimumab (n=22) or ipilimumab plus nivolumab (n=35) in the second-line setting. Median survival from initiation of second-line therapy was 6 months for those treated with ipilimumab alone and 5.6 months for those treated with combination ipilimumab and anti-PD-1 antibodies (p=0.81).

“Anti-PD-1 antibodies are commonly used as frontline therapy for patients with metastatic melanoma,” the investigators said. “Although these medications can cause long-term responses, a significant number of patients will not respond or will lose response.”