Melanoma Outcomes Improved With Nivolumab Alone or Plus Ipilimumab

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Systemic review and meta-analysis evaluated the efficacy of nivolumab vs ipilimumab, in combination, as monotherapy, or vs other treatment options for the treatment of metastatic melanoma.
Systemic review and meta-analysis evaluated the efficacy of nivolumab vs ipilimumab, in combination, as monotherapy, or vs other treatment options for the treatment of metastatic melanoma.

Nivolumab monotherapy or in combination with ipilimumab leads to significantly improved outcomes among patients with metastatic melanoma compared with ipilimumab alone, according to an article published in Melanoma Research.

For this systemic review and meta-analysis, researchers reviewed the results of 4 randomized clinical trials that included 1910 patients with advanced unresectable melanoma. The 4 interventions included nivolumab alone or with ipilimumab vs ipilimumab alone, nivolumab vs dacarbazine, nivolumab plus ipilimumab vs ipilimumab monotherapy, and nivolumab vs investigator's choice chemotherapy.

Overall effect estimates showed that nivolumab plus ipilimumab had significantly better objective response rate, complete response rate, partial response rate, stable disease rate, and progression-free survival (PFS) compared with ipilimumab alone.

Nivolumab monotherapy also had significantly improved outcomes compared with chemotherapy alone, with improved objective response rate, partial response rate, stable disease rate, and PFS.

Among patients without BRAF mutations, nivolumab groups had significant improvements in overall survival and objective response rates.

The safety profile of nivolumab and ipilimumab were comparable, with similar rates of incidence and discontinuations due to grade 3 to 4 adverse events (AEs). Grade 3 to 4 AEs included fatigue, rash, vomiting, dyspnea, and arthralgia.

The authors concluded that “nivolumab alone or combined with ipilimumab significantly improves the overall response rate, including the complete response, compared with ipilimumab alone. In addition, nivolumab results in longer progression-free survival with a comparable safety profile.”

Reference

Menshawy A, Eltonob AA, Barkat SA, et al. Nivolumab monotherapy or in combination with ipilimumab for metastatic melanoma: systematic review and meta-analysis of randomized-controlled trials [published online June 27, 2018]. Melanoma Res. doi: 10.1097/CMR.0000000000000467

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