Lancet Oncol: Ipilimumab combined with anti-PD-1 therapy significantly improved the clinical prognosis of patients with advanced melanoma resistant to PD-1

Anti-PD-1 therapy (anti-PD-1 for short) can make about 30% of patients with metastatic melanoma obtain a long-term stable course; however, about two-thirds of patients are resistant and require further treatment.

This study aims to evaluate ipilimumab combined with anti-PD-1 (pembrolizumab or nivolumab) vs.

This is a multi-center, retrospective cohort study conducted in 15 melanoma centers in multiple countries, recruiting unresectable metastatic stage III or IV melanoma patients over 18 years of age to fight PD- (L)1 Tolerance (primary or acquired resistance).

From February 1, 2011 to February 6, 2020, a total of 355 patients with metastatic melanoma resistant to PD-(L)1 (nivolumab, ranked monoclonal antibody, or atuzumab) were recruited Among them, 162 (46%) patients received ipilimumab monotherapy, and 193 (54%) patients received ipilimumab combined with anti-PD-1 therapy.

Objective response rate subgroup analysis

At a median follow-up of 22.

Overall survival and progression-free survival

The overall survival and progression-free survival of the combination therapy group were also significantly longer than those of the monotherapy group (median overall survival: 20.

Adverse events

The proportion of patients who reported grade 3-5 adverse events between the two groups was similar (combination group vs single-agent group: 31% vs 33%).

To sum up, in patients with melanoma who are resistant to anti-PD-(L)1 therapy, the efficacy of ipilimumab combined with anti-PD-1 therapy is significantly higher than that of ipilimumab monotherapy, which not only improves the objective remission rate, but also Both progression-free survival and overall survival were significantly prolonged .

Ines Pires da Silva, et al.