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ASCO 2019: Nivolumab Plus Ipilimumab for Symptomatic Melanoma Brain Metastases

By: Hillary Ojeda
Posted: Monday, June 10, 2019

At the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, updated data from the CheckMate 204 trial indicate “a high rate of durable intracranial responses” with the combination of nivolumab plus ipilimumab in patients with asymptomatic melanoma brain metastases (Abstract 9501). In addition, the first report of this combination immunotherapy in patients with symptomatic melanoma brain metastases showed intracranial antitumor activity. Hussein Abdul-Hassan Tawbi, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, noted that further studies are necessary to clarify immunotherapy resistance in patients with symptomatic melanoma brain metastases.

“In patients with asymptomatic melanoma brain metastases our updated results show a high rate of durable intracranial responses, further supporting nivolumab plus ipilimumab as a first-line treatment in this population,” they concluded.

In the CheckMate 204 study, patients were separated into two groups: those without neurologic symptoms (n = 101) and those with neurologic symptoms (n = 18). Both received nivolumab at 1 mg/kg plus ipilimumab at 3 mg/kg every 3 weeks x 4, then nivolumab at 3 mg/kg every 2 weeks until disease progression or toxicity.

The clinical benefit rate for the asymptomatic group was 58.4%, after a median follow-up of 20.6 months. As for the symptomatic group, the intracranial objective response rate was 16.7%, and the clinical benefit rate was 22.2%, after a median follow-up of 5.2 months. As for toxicity, grade 3 or 4 adverse events occurred in 54.5% of patients with asymptomatic disease and 55.6% of those with symptomatic disease.

Disclosure: The study authors’ disclosure information may be found at coi.asco.org.



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