Im­munother­apy combo ‘packs punch’ against melanoma


Im­munother­apy, which har­nesses the power of the im­mune sys­tem in or­der to attack can­cer, is more po­tent against melanoma when two agents are com­bined, but side ef­fects rise too, re­searchers said Sun­day.

Find­ings of a ran­dom­ized phase III trial com­pared nivolumab (Op­divo) alone or in com­bi­na­tion with ip­il­i­mumab (Yer­voy) and found the pair was “sig­nif­i­cantly more ef­fec­tive than ip­il­i­mumab alone,” ac­cord­ing to the re­sults pre­sented at the Amer­i­can So­ci­ety of Clin­i­cal On­col­ogy con­fer­ence in Chicago.

Both drugs are known as check­point in­hibitors which boost the im­mune sys­tem’s abil­ity to tackle tu­mors, and are made by the phar­ma­ceu­ti­cal com­pany Bris­tol My­er­sSquibb, which funded the study.

Op­divo and Yer­voy are mon­o­clonal an­ti­bod­ies that block dif­fer­ent im­mune check­points. Op­divo blocks PD-1 and Yer­voy blocks CTLA-4, mak­ing it eas­ier for the im­mune sys­tem to attack can­cer.

Both have been ap­proved by the U.S. Food and Drug Ad­min­is­tra­tion for use as sin­gle agents in pa­tients whose melanoma can­not be re­moved by surgery, or whose melanoma has spread to other or­gans and no longer re­sponds to other drugs.

The com­bined treat­ment, which con­sists of four doses, costs about US$125,000.

In 945 pa­tients who were never treated be­fore for their ad­vanced skin can­cer, the re­search found that Op­divo alone was far bet­ter than Yer­voy when it came to ex­tend­ing the time be­fore the can­cer be­gan to ad­vance again.

Yer­voy stopped melanoma from pro­gress­ing for nearly three months, while Op­divo did so for nearly seven months.

But when taken to­gether, the pair staved off melanoma pro­gres­sion for 11.5 months, the study found.

Melanoma is the dead­li­est form of skin can­cer, and some 132,000 cases are di­ag­nosed each year world­wide.

Im­munother­apy doesn’t work for ev­ery­one, and re­searchers are still work­ing to fig­ure out why.

In the cur­rent study, those tak­ing the duo were far more likely to see their tu­mors shrink (57.6 per­cent of pa­tients showed some re­sponse) than Op­divo (43.7 per­cent) alone.

Among those tak­ing Yer­voy alone, 19 per­cent re­sponded to the treat­ment by experiencing tu­mor shrink­age, but 5 per­cent ac­tu­ally saw their can­cer grow.

Re­searchers also noted that se­ri­ous drug-re­lated side ef­fects were re­ported by more than half of those in the com­bi­na­tion group (55 per­cent), and 36 per­cent of pa­tients in this group had to stop the ther­apy due to side ef­fects.

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