Ipilimumab alone or in combination with nivolumab after progression on anti-PD-1 therapy in advanced melanoma. (April 2017)

• Record Type: Journal Article
• Authors: Zimmer, Lisa; Apuri, Susmitha; Eroglu, Zeynep; Kottschade, Lisa A.; Forschner, Andrea; Gutzmer, Ralf; Schlaak, Max; Heinzerling, Lucie; Krackhardt, Angela M.; Loquai, Carmen; Markovic, Svetomir N.; Joseph, Richard W.; Markey, Kelly; Utikal, Jochen S.; Weishaupt, Carsten; Goldinger, Simone M.; Sondak, Vernon K.; Zager, Jonathan S.; Schadendorf, Dirk; Khushalani, Nikhil I.
• Is Part Of: European journal of cancer. Volume 75(2017)
• Page Start: 47
• Page End: 55
• Publication Date: 2017-04
• Subjects: Nivolumab -- Pembrolizumab -- Treatment failure -- Efficacy -- Ipilimumab -- Ipilimumab and nivolumab -- Melanoma -- Disease progression -- Anti-PD-1; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2017.01.009
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Background: The anti-programmed cell death-1 (PD-1) inhibitors pembrolizumab and nivolumab alone or in combination with ipilimumab have shown improved objective response rates and progression-free survival compared to ipilimumab only in advanced melanoma patients. Anti-PD-1 therapy demonstrated nearly equal clinical efficacy in patients who had progressed after ipilimumab or were treatment-naïve. However, only limited evidence exists regarding the efficacy of ipilimumab alone or in combination with nivolumab after treatment failure to anti-PD-therapy. Patients and methods: A multicenter retrospective study in advanced melanoma patients who were treated with nivolumab (1 or 3 mg/kg) and ipilimumab (1 mg or 3 mg/kg) or ipilimumab (3 mg/kg) alone after treatment failure to anti-PD-1 therapy was performed. Patient, tumour, pre- and post-treatment characteristics were analysed. Results: In total, 47 patients were treated with ipilimumab (ipi-group) and 37 patients with ipilimumab and nivolumab (combination-group) after treatment failure to anti-PD-1 therapy. Overall response rates for the ipi- and the combination-group were 16% and 21%, respectively. Disease control rate was 42% for the ipi-group and 33% for the combination-group. One-year overall survival rates for the ipi- and the combination-group were 54% and 55%, respectively. Conclusions: Ipilimumab should be considered as a viable treatment option for patients with failure to prior anti-PD-1 therapy, including those with progressive disease as best response to prior anti-PD-1. In contrast, the combination of ipilimumab and nivolumab appears significantly less effective in this setting compared to treatment-naïve patients. Highlights: Ipilimumab after failure to anti-PD-1 therapy in melanoma elicits similar response rates as treatment-naïve patients. Ipilimumab should be considered an appropriate option for patients who progressed on prior anti-PD-1 therapy. Overall response rate of ipilimumab and nivolumab after failure to anti-PD-1 is lower compared to treatment-naïve patients. Response to prior anti-PD-1 had no impact on subsequent response to ipilimumab or to its combination with nivolumab.