NEJM news: combined immunotherapy significantly improves the long-term survival rate of melanoma patients

October 17, 2019 / bioun / - according to a study by the NHS Foundation in Royal Marsden, a combination of two immunotherapeutic drugs, ipilimumab and nivolumab, has prevented or reversed the progression of advanced melanoma in five years or more Just 10 years ago, only one in 20 patients with advanced melanoma survived five years, while many survived only six to nine months The results of checkmate 067 trial, the longest three-phase follow-up clinical trial of checkpoint inhibitor combination therapy, were published recently at the 2019 ESMO annual meeting in Barcelona, Spain, and also in the New England Journal of medicine Photo source: James Larkin, a cancer consultant at the NHS Foundation in Royal Marsden, Wikipedia and professor at the British Cancer Research Institute (ICR), introduced the results "In the past, metastatic melanoma was considered incurable," he said Oncologists believe that melanoma, unlike other cancers, cannot be treated once it spreads This is the first time we can say that the long-term survival rate of advanced melanoma is now over 50%, which is a huge milestone "In this study, 945 patients with advanced melanoma were randomly divided into three groups: 314 patients received" double hit "from nivolumab and ipilimumab; 316 patients received nivolumab + placebo treatment; 315 patients received ipilimumab + placebo treatment Each nivolumab was compared separately with ipilimumab until disease progression or any side effects became unacceptable The overall 5-year survival rate of nivolumab combined with ipilimumab was 52%, and 74% of the patients had no treatment after 5 years The overall survival rate of nivolumab was 44%, and that of ipilimumab was 26% Professor Larkin said: "when you put these two drugs together, you're actually putting two brakes on the immune system, not one In this way, the immune system can recognize tumors that it did not recognize before and react to destroy them "It is important that for those who stop treatment because of side effects such as fatigue, rashes and diarrhea, the results are as good as for those who take the combination medication for a long time A key point about immunotherapy is that the immune system can be re educated even if the treatment time is short This is in contrast to other treatments such as chemotherapy, which requires a complete course of treatment to achieve the same effect Pamela Smith, 67, took part in the checkmate 067 clinical trial in January 2014 shortly after discovering the spread of her own melanoma "There was no surgery, so this trial was my only option," Pamela said I was treated every two weeks for about four months, and as a result I had severe diarrhea and had to stop Surprisingly, the first scan and every subsequent scan showed that it succeeded in a relatively short period of time My tumor has shrunk to less than half of its original size and hasn't changed in five years I haven't had any treatment since then and I feel great "Reference: James Larkin et al Five year survival with combined nivolumab and ipilimumab in advanced melanoma The New England Journal of medicine September 282019 doi: 10.1056/nejmoa1910836