An early assessment of overall survival showed a 6-month overall survival rate of 92.3% and a 9-month overall survival rate of 82.8%. The 1-year estimated survival was 81.5%.

Grade 3 or 4 adverse events occurred in 55% of patients, including events involving the central nervous system in 7% of patients. There was one death from immune-related myocarditis.

“The response rate of this combination immunotherapy regimen is remarkable, although the responses appear less durable compared to metastatic disease outside of the brain,” commented Patrick Ott, MD, PhD, clinical director of the Melanoma Center at Dana Farber Cancer Center in Boston, Massachusetts. “The results have already changed the standard of care for many melanoma patients with metastases in the brain since the data were presented at ASCO last year.“

According to Dr Ott, the treatment will very likely also be used in patients who would not have been candidates for the trial because their metastases were symptomatic or larger than allowed on the trial.

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“It will be interesting to learn about the outcomes for these patients who have a higher burden of metastatic disease in the brain,” Dr Ott told Cancer Therapy Advisor. “It is encouraging to have this systemic treatment available in patients with brain metastases from melanoma. We will have to learn how to best combine and sequence combination immunotherapy with surgical resection and radiation therapy.”

References

  1. Tawbi HA, Forsyth PA, Algazi A, et al. Combined nivolumab and ipilimumab in melanoma metastatic to the brain. N Engl J Med. 2018;379:722-730. doi: 10.1056/NEJMoa1805453.
  2. Tawbi HA, Forsyth PA, Algazi A, et al. Efficacy and safety of nivolumab (NIVO) plus ipilimumab (IPI) in patients with melanoma (MEL) metastatic to the brain: Results of the phase II study CheckMate 204. J Clin Oncol. 2017;35(suppl; abstr 9507).