Could Combining Nivolumab and Ipilimumab Be More Advantageous in Advanced Melanoma?

According to a study presented at the 2014 American Society of Clinical Oncology (ASCO) meeting, combined ipilimumab-nivolumab provided average survival of 40 months in advanced melanoma (skin cancer).

Skin cancer is among the most common cancers, accounting for approximately half of all cases. Melanoma begins in pigment-producing melanocytes and is rarer than other skin cancers but more serious. Although accounting for approximately %5 of skin cancers, it causes the most skin cancer deaths.

In advanced melanoma, surgery and radiotherapy are used only to relieve painful symptoms and improve quality of life, while chemotherapy and/or immunotherapy (biological therapy) are the main treatments. Escaping immune surveillance is a known cancer cell characteristic. Immunotherapy, triggering immunity against cancer cells to help the body fight cancer, has therefore been an important strategy studied for years.

Ipilimumab (yervoy) or nivolumab (opdivo), commonly used in immunotherapy, contribute somewhat to survival in advanced melanoma. A recent ASCO study, however, showed a much greater advantage from their combination. Initial findings were published last year, and updated follow-up results were presented at this year's meeting.

The study regularly administered concurrent ipilimumab and nivolumab to 53 advanced melanoma patients and followed them. At year 1, survival was %85; at year 2, %79. Average survival was 40 months. Overall response was %40; among 17 receiving high doses, response was %53. In %42 of patients, tumors shrank by at least %80.

In conclusion, combined ipilimumab and nivolumab produced unprecedented survival rates in advanced melanoma, exciting many oncologists. This new strategy may become widely used in the coming period. However, the number of study patients is insufficient for clinical implementation. Caution and awaiting further studies in more patients are therefore advisable.