Immunotherapy drugs can prolong survival in people with advanced melanoma

A ten-year patient follow-up study shows that a combination of two immunotherapy drugs can significantly extend the survival of people with advanced melanoma. Photo by Adobe Stock/HealthDay News

Ten years of patient follow-up show that a combination of two immunotherapy drugs can significantly prolong survival in people with advanced melanoma.

In 2011, a diagnosis of advanced, metastatic melanoma typically meant death within 6.5 months, researchers at Weill Cornell Medicine in New York City found.

By 2024, the combination of the two drugs nivolumab and ipilimumab could extend this survival time by six years and possibly even more, said researchers led by Dr. Jedd Wolchok, a professor of medicine at Weill Cornell University, where he also heads the Sandra and Edward Meyer Cancer Center.

“This study is a practice changer,” Wolchok said in a Weill Cornell press release. “The median survival time for this group of patients is now just over six years, and people who do not experience cancer progression after three years have a high probability of still being alive and disease-free after 10 years.”

The results were published Sunday in the New England Journal of Medicine. The study was funded by Bristol-Myers Squibb, the manufacturer of nivolumab (Opdivo) and ipilimumab (Yervoy).

Both drugs belong to a class of cancer drugs called immune checkpoint inhibitors. These drugs work by turning off an important cellular mechanism that would otherwise signal the immune system's T cells not to attack a cancer cell.

In this way, nivolumab and ipilimumab make cancer cells vulnerable to destruction by the immune system again.

The effectiveness of this approach against metastatic melanoma was tested in the new study. Researchers followed 10-year outcomes in 945 patients with advanced melanoma treated at centers in 21 countries worldwide.

The new report provides the final data from the study, which will be completed after a decade.

It turned out that the use of nivolumab alone or in combination with ipilimumab was more effective than the use of ipilimumab alone.

Not only did the study confirm that the drugs extended expected survival by years, it also found that there was no increase in side effects from the treatment regimens during the 10-year trial period.

This was a concern because the drugs must be taken long-term, the researchers noted. However, according to the Weill Cornell press release, no “long-term toxicities” occurred.

“This follow-up study further underscores the progress we have made in treating patients with advanced melanoma with immunotherapy and how the situation has changed so dramatically,” said Dr. Jeffrey Farma, chief of the department of surgery at Fox Chase Cancer Center in Philadelphia.

“This study confirms that there is a sustained survival benefit even after 10 years,” said Farma, who was not involved in the new study.

According to the study's co-lead author, Dr. F. Stephen Hodi, the study is now “an important part of our conversations with patients about the durable benefits of immune checkpoint therapy and the potential of combining multiple immunotherapies to improve treatment outcomes.” Hodi directs the Melanoma Center and the Center for Immuno-Oncology at the Dana-Farber Cancer Center in Boston.

“After a decade of follow-up, we can now confidently tell our patients that there are treatment options that have the potential to transform metastatic melanoma into a manageable, long-term condition, giving them confidence for the future,” Hodi said.

This news should reassure many patients. Patients who have beaten their cancer after three or five years of therapy with immune checkpoint inhibitors are likely to continue to do so, and follow-up visits with oncologists may even be required less frequently, the researchers say.

“We're trying to get them to have a mindset of hope and more optimistic expectations,” said Wolchok, who also serves as a paid consultant to the Bristol Myers Fund. “We can now say that half of the patients treated with this combination therapy will live 10 years or more without fear of dying from metastatic melanoma.”

More information

Learn more about melanoma treatment at the American Cancer Society.