Dr. Sznol Discusses the Combination of Ipilimumab and Nivolumab in Melanoma

Source: OncLive, November 2019

Mario Sznol, MD, professor of medicine, co-director, Yale SPORE in Skin Cancer, Yale Cancer Center, discusses the benefits of immunotherapy, specifically the combination of the CTLA-4 inhibitoripilimumab (Yervoy) and the PD-1 inhibitor nivolumab (Opdivo), in melanoma.

Historically, 5-year overall survival (OS) in this population was 5% to 10%. With the addition of checkpoint inhibitors, that percentage has increased ten-fold to nearly 50%, says Sznol.

However, the risk-benefit ratio with the combination therapy is not as compelling, explains Sznol. As reported in the randomized phase III CheckMate 067 trial, the combination of nivolumab and ipilimumab induced a 4-year OS benefit of 53% versus 46% with nivolumab alone in patients with previously untreated advanced melanoma. Moreover, grade 3/4 treatment-related adverse events,including diarrhea and high levels of lipase, occurred in 59% of patients on the combination compared with 22% on nivolumab alone.