Neoadjuvant Nivolumab/Ipilimumab Shows Early Promise for Stage III Melanoma

Source: OncLive, November 2016

Neoadjuvant therapy with the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) is plausible and effective but can induce a high level of adverse events (AEs) calling for further research into better tolerated dosing schemes, according to findings from the OpACIN trial presented at the 2016 Society for Melanoma Research Annual Meeting.

“Ipilimumab plus nivolumab in the neoadjuvant setting is feasible, and all patients underwent a lymph node dissection on time," said lead investigator Christian U. Blank, MD, a medical oncologist at The Netherlands Cancer Institute, Amsterdam, Netherlands. “However, we saw a high percentage of grade 3/4 toxicities, resulting in only 2 of the 18 patients receiving the full courses of ipilimumab plus nivolumab."

In the phase Ib study, 20 patients were treated with nivolumab plus ipilimumab before or after surgery for stage III palpable melanoma with no in-transit metastases in the last 6 months. Across both arms, ipilimumab was administered at 3 mg/kg and nivolumab was given at 1 mg/kg every 3 weeks. In the neoadjuvant arm, patients received 2 cycles of therapy prior to surgery followed by 2 cycles of the combination after resection. In the adjuvant arm, 4 cycles of nivolumab and ipilimumab were administered following resection.