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Immunotherapy combination dramatically improves long-term survival for melanoma patients


immune checkpoint inhibitors
Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check (left). immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel). Graphic credit – Terese Winslow via National Cancer Institute

CANCER DIGEST – Sept. 16, 2024 – Long-term data from an international trial of immunotherapy for advanced melanoma show longer overall survival for patients who responded to a combination of two immunotherapies compared to patients treated with single immunotherapy drugs. The 10-year followup study was published in the Sept. 15, 2024 New England Journal of Medicine.


The study called CheckMate 067, involved 945 patients treated at 137 cancer centers in 21 countries. The study followed long-term outcomes for patients treated with one of three immunotherapy regimens. One-third received nivolumab plus ipilumumab, one third received nivolumab with a placebo and the remaining third received ipilumumab plus placebo.

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After 10 years of follow up the median overall survival was 71.9 months for the nivolumab plus ipilumumab group, 36.9 months for the nivolumab group, and 19.9 months for those treated with ipilimumab.


“This was a practice-changing trial,” first author Dr. Jedd Wolchok, director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine said in a press release. “The median survival for this population is now a little over six years, and people who are free from cancer progression at three years have a high likelihood of remaining alive and disease-free at the 10-year time point.”


In 2011, the median survival for patients with metastatic melanoma was just six and half months. Immunotherapies that emerged at that time encourage the immune system to attack the cancer. Nivolumab and ipilimumab belong to a type of immunotherapy called check-point inhibitors. Checkpoints are proteins found on immune system cells and some cancer cells that can prevent the immune system from responding too strongly or even block T cells from killing cancer cells.


Immune checkpoint inhibitors work by blocking checkpoint proteins, which allows T cells to kill cancer cells. These types of drugs have been shown to highly effective in treating several types of cancer, including melanoma, lung, bladder, breast, head and neck, Hodgkins lymphoma, and kidney cancers.


Some of these immunotherapies include pembrolizumab (Keytruda®), ipilimumab (Yervoy®), nivolumab (Opdivo®), and atezolizumab (Tecentriq®)


In addition to confirming the long-term survival of about half of the patients treated with the combination immunotherapy, the study showed no new complications or side effects over time from treatment with the drugs.


The study also showed that patients who were doing well at three years or five years after treatment were likely to continue doing well, which could allow them to reduce the number and frequency of follow-up visits and tests.


“We can now say half of patients treated with this combination therapy will live 10 years or longer without the concern of dying from metastatic melanoma,” said Dr. Wolchok.


Dr. Jedd Wolchok is a paid consultant for Bristol Myers Fund, Inc., which partially funded the study along with a grant (P30CA008748) from the US National Cancer Institute; and a grant from the UK National Institute for Health Research Royal Marsden–Institute of Cancer Research Biomedical Research Centre.


Sources; Weill Cornell Medicine press release, and New England Journal of Medicine

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