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Combined ipilimumab and nivolumab first‐line and after BRAF‐targeted therapy in advanced melanoma
Author(s) -
Mason Robert,
Dearden Helen C.,
Nguyen Bella,
Soon Jennifer A.,
Smith Jessica Louise,
Randhawa Manreet,
Mant Andrew,
Warburton Lydai,
Lo Serigne,
Meniawy Tarek,
Guminski Alexander,
Parente Phillip,
Ali Sayed,
Haydon Andrew,
Long Georgina V.,
Carlino Matteo S.,
Millward Michael,
Atkinson Victoria G.,
Menzies Alexander M.
Publication year - 2020
Publication title -
pigment cell and melanoma research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.618
H-Index - 105
eISSN - 1755-148X
pISSN - 1755-1471
DOI - 10.1111/pcmr.12831
Subject(s) - ipilimumab , nivolumab , medicine , melanoma , oncology , adverse effect , cohort , population , targeted therapy , expanded access , clinical trial , combination therapy , cancer research , cancer , immunotherapy , environmental health
The combination of ipilimumab and nivolumab is a highly active systemic therapy for metastatic melanoma but can cause significant toxicity. We explore the safety and efficacy of this treatment in routine clinical practice, particularly in the setting of serine/threonine‐protein kinase B‐Raf (BRAF)‐targeted therapy. Consecutive patients with unresectable stage IIIC/IV melanoma commenced on ipilimumab and nivolumab across 10 tertiary melanoma institutions in Australia were identified retrospectively. Data collected included demographics, response and survival outcomes. A total of 152 patients were included for analysis, 39% were treatment‐naïve and 22% failed first‐line BRAF/MEK inhibitors. Treatment‐related adverse events occurred in 67% of patients, grade 3–5 in 38%. The overall objective response rate was 41%, 57% in treatment‐naïve and 21% in BRAF/MEK failure patients. Median progression‐free survival was 4.0 months (95% CI, 3.0–6.0) in the whole cohort, 11.0 months (95% CI, 6.0‐NR) in treatment‐naïve and 2.0 months (95% CI, 1.4–4.6) in BRAF/MEK failure patients. The combination of ipilimumab and nivolumab can be used safely and effectively in a real‐world population. While first‐line efficacy appears comparable to trial populations, BRAF‐mutant patients failing prior BRAF/MEK inhibitors show less response.