The following is a summary of “Final, 10-Year outcomes with Nivolumab plus Ipilimumab in advanced melanoma,” published in the September 2024 issue of Dermatology by Wolchok et al.

Researchers conducted a retrospective study to analyze long-term effects in patients with advanced melanoma treated with nivolumab plus ipilimumab, nivolumab, or ipilimumab monotherapy, given the high survival rates observed in prior trials.

They examined patients randomly grouped with previously untreated advanced melanoma, assigning them in a 1:1:1 ratio to nivolumab plus ipilimumab, nivolumab, or ipilimumab monotherapy. Treatment persisted until disease progression, unacceptable toxic effects, or withdrawal of consent. Randomization was stratified by BRAF mutation status, metastasis stage, and programmed death ligand 1 expression, presenting a report of final 10-year results, with overall survival, melanoma-specific survival, and durability of response.

The results showed a minimum follow-up of 10 years; median overall survival was 71.9 months with nivolumab plus ipilimumab, 36.9 months with nivolumab, and 19.9 months with ipilimumab. The hazard ratio for death was 0.53 (95% CI, 0.44 to 0.65) for nivolumab plus ipilimumab compared to ipilimumab, and 0.63 (95% CI, 0.52 to 0.76) for nivolumab compared to ipilimumab. Median melanoma-specific survival was more than 120 months with nivolumab plus ipilimumab (not reached, with 37% of patients alive at the end of the trial), 49.4 months with nivolumab, and 21.9 months with ipilimumab, from patients alive and progression-free at 3 years, 10-year melanoma-specific survival was 96% with nivolumab plus ipilimumab, 97% with nivolumab, and 88% with ipilimumab.

They concluded a continued, long-term survival benefit for nivolumab plus ipilimumab and nivolumab monotherapy compared to ipilimumab monotherapy in patients with advanced melanoma.

Source: nejm.org/doi/full/10.1056/NEJMoa2407417