A new treatment based on combining two drugs—nivolumab and ipilimumab—may represent a milestone in how we treat skin cancer patients. More than half of these patients can now survive the condition (considered untreatable just a decade ago) thanks to a study led by the Royal Marsden NHS Foundation Trust found. This major milestone means that more lives with those struggling with advanced melanoma can be saved immediately.
A decade ago, only half of skin cancer patients survived melanoma with many dying within months of diagnosis. Moreover, about 1 in every 20 patient with advanced melanoma survived a decade ago. With the latest study results from the Royal Marsden, new hope for advanced melanoma patients is at hand when combining Bristol-Myers Squibb’s nivolumab (Opdivo) and ipilimumab (Yervoy).
The Checkmate 067 Trial
The Checkmate 067 trial occurred from 2013 and runs through 2021—it is sponsored by American pharmaceutical company Bristol-Myers Squib. It involved over 140 clinical investigational sites, including Royal Marsden NHS Foundation Trust. The trial saw 945 patients with advanced melanoma randomized into three groups including: 1) 314 patients received the ‘double-hit’ of nivolumab plus Ipilimumab; 2) 316 patients received nivolumab plus a placebo; and 3) 315 patients received ipilimumab plus placebo. Each nivolumab arm was compared to ipilimumab by itself, and was administered until the disease progressed or until any side-effects became unacceptable.
The Results: Amazing
The five-year overall survival rate for the combination of nivolumab plus ipilimumab was 52%, with 74% of those patients treatment-free after five years. The overall survival rate for nivolumab was 44% and 26% for ipilimumab.
The results of the study titled “Five-Year Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma” was published in the New England Medicine of Journal on September 28, 2019.
Lead Investigator: A ‘Huge Milestone’
Professor James Larkin, Consultant Medical Oncologist with The Royal Marsden NHS Foundation Trust, and Professor at the Institute of Cancer Research (ICR), presented the results recently noting, “In the past, metastatic melanoma was regarded as untreatable. Oncologist considered melanoma different to other cancers. It couldn’t be treated once it had spread. This is the first time we can say that the chances of being a long-term survivor of advanced melanoma are now over 50 per cent, which is a huge milestone”
Effective Even When Stopping due to Side-Effects
Some patients had to stop due to intense side-effects such as fatigue, skin rashes and diarrhea; however, the outcome was just as good as it was for those who were on the combination for longer. A key factor with the immunotherapies centers on the fact that the immune system can be reeducated even with shorter durations of treatment. This lies in stark contract to treatments such as chemotherapy, which can require a full course to be effective.
A Patient’s Story: Pamela Smith of the UK
Pamela joined the Checkmate 067 trial in January 2014 right after she found out her melanoma had spread. Ms. Smith noted, “It was inoperable, so the trial was my only option. I’d been having treatment every two weeks for about four months when I developed diarrhea that was so bad I had to come off treatment. Amazingly, the first scan and every scan since has shown that in that relatively short time, it worked. My tumor shrank to less than half of its original size and it hasn’t changed in five years. I’ve not had any treatment since and I feel brilliant. At every appointment at the Royal Marsden, they ask how I feel on a scale of 1 to 100 and I answer 100. I feel well and very lucky to be alive, and to be able to spend time with my eight grandchildren.”
About Royal Marsden
Launched in 1851, it is the world’s oldest hospital dedicated to cancer diagnosis, treatment, research and education. Together with its academic partner called the Institute of Cancer Research (ICR), the Royal Marsden is the largest and most comprehensive cancer center in Europe—seeing over 55,000 NHS and private patients each year. It is a center of excellence with an international reputation for ground-breaking research and pioneering the very latest in cancer treatments and technologies. Combined with the ICR, it is the only National Institute for Health Research Biomedical Research Center for Cancer.
James Larkin, FRCP, PhD, ICR
Call to Action: Have you or a loved one been diagnosed with advanced melanoma? Note these results and contact your physician about the possibility of this treatment.