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ABC Trial: Nivolumab Plus Ipilimumab for Melanoma Brain Metastases

By: Joseph Fanelli
Posted: Tuesday, December 10, 2019

Based on the long-term outcomes of the phase II ABC trial, presented at the 2019 European Society for Medical Oncology (ESMO) Congress in Barcelona (Abstract 1311O), using nivolumab plus ipilimumab before surgery or radiation therapy resulted in more “durable” intracranial responses for patients with melanoma brain metastases. The upfront treatment demonstrated positive responses in the majority of patients enrolled, with no new adverse events reported, according to Georgina V. Long, PhD, of the Melanoma Institute Australia and the Royal North Shore Hospital at the University of Sydney, and colleagues.

In this collaboration study, the investigators divided 76 patients into three cohorts. Patients with asymptomatic brain metastases, and no prior local brain therapy, were placed in cohorts A and B; they received either nivolumab plus ipilimumab or nivolumab alone, respectively. All patients who previously experienced a failed local therapy, exhibited neurologic symptoms, and had leptomeningeal disease were placed in cohort C; they were treated with nivolumab alone.

In cohorts A, B, and C, the patients exhibited intracranial response rates of 51%, 20%, and 6%, respectively, and extracranial response rates of 57%, 29%, and 25%, respectively. A complete intracranial response was observed in cohorts A (26%) and B (16%). Patients treated with nivolumab plus ipilimumab in cohort A had intracranial progressive-free survival rates of 49% at both 12 months and 24 months and a 63% overall survival rate at 12 and 24 months. Cohorts B and C both had lower intracranial progressive-free and overall survival rates at 12 and 24 months. Additionally, for the 27 treatment-naive patients in cohort A, an intracranial response rate of 59% and a 24-month intracranial progression-free survival rate of 56% were reported.

No treatment-related deaths were reported for any of the cohorts. Treatment-related adverse events of grade 3 or 4 toxicity occurred in 54% of those in cohort A, 20% of those in cohort B, and 13% of those in cohort C.

Disclosure: For full disclosures of study authors, visit esmo.org.



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