Photo Credit: Malikov Aleksandr

The following is a summary of “Efficacy and safety of first-line metastatic melanoma treatment with ipilimumab + nivolumab versus nivolumab in a real-world setting,” published in the November 2024 issue of Dermatology by Karine et al. 

The Checkmate 067 trial demonstrated improved progression-free survival and numerically superior overall survival for the combination of ipilimumab and nivolumab compared to standard-of-care therapy in advanced melanoma.  

Researchers conducted a retrospective study to compare the efficacy and safety of nivolumab versus ipilimumab + nivolumab as first-line treatments for metastatic melanoma.  

They included patients from the French Melbase cohort between 2013 and 2022, with first-line treatment for stage-IIIc or -IV melanoma and receiving nivolumab or ipilimumab + nivolumab. The primary endpoint was overall survival at 36 months, while secondary endpoints included progression-free survival at 36 months, best radiological response, and safety. Propensity score matching using IPTW method was performed to address confounding factors, along with a subgroup analysis of brain metastasis, LDH levels, and BRAF mutation status.  

The results showed that 406 patients were treated with nivolumab and 416 with ipilimumab + nivolumab. At 36 months, overall survival was higher in the ipilimumab + nivolumab group (57.1% [95%CI 50.7-64.2]) compared to the nivolumab group (46.6% [95%CI 41.6-52.1]), with a hazard ratio (HR) of 1.4 (1.1;1.8). Progression-free survival at 36 months was significantly better in the ipilimumab + nivolumab group (42.3%) vs the nivolumab group (21.9%), with an HR of 1.6 (1.4;1.9). The objective response rate was 44% in both groups. The overall incidence of side effects was similar (82% vs 84%), while severe toxicity (grade ≥ 3) occurred more frequently in the ipilimumab + nivolumab group (29% vs 41%) but without statistical significance.  

Investigators concluded that the findings were generally consistent with the Checkmate 067 trial, with lower objective response rates and toxicity profiles observed in the analysis. 

Source: academic.oup.com/bjd/advance-article-abstract/doi/10.1093/bjd/ljae470/7911896