Immunotherapy drug combination shows promise for advanced melanoma patients

In collaboration with the Press Association

Two immunotherapy drugs could be better than one - at least for a subset of patients with advanced melanoma, according to a preliminary US trial.

“Using two antibodies together will make an important difference to the treatment of melanoma, and potentially other cancers too" - Professor Peter Johnson, Cancer Research UK

But the study also showed higher rates of serious side effects among patients who were given the combination.

The trial, run by scientists from the Dana-Farber Cancer Institute and Harvard Medical School in Boston, found that a higher proportion of patients with advanced melanoma responded to a combination of ipilimumab (Yervoy) and nivolumab than they did to ipilimumab alone.

Both of the drugs work by targeting proteins on a patient’s immune cells that allow them to more effectively attack their cancer. 

Trials have shown that they can be extremely effective, but only for a minority of patients. So understanding how best to use them is a key focus for cancer researchers.

The patients who received the combination were more likely to show signs of responding, and there were data to suggest that the disease took longer to return. But the study will need to be followed up for longer to confirm this.

The study, published in the New England Journal of Medicine, involved 142 patients with advanced melanoma who had not received prior therapy.

A total of 95 patients received the drug combination. The other 47 were given ipilimumab along with a placebo.

56 patients given the combination responded to the drug, 21 of whom had a complete response, where no sign of the tumour remained. 

This compared with just five patients who responded to ipilimumab, none of whom had a complete response. 

But just over half (54 per cent) of the patients on the combination therapy had serious side effects, compared with a quarter (24 per cent) on the single drug treatment.

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “The pace of progress with immune treatments for cancer is really impressive. 

“Using two antibodies together will make an important difference to the treatment of melanoma, and potentially other cancers too, although the side effects can also be serious. 

“We know that this type of treatment has great power, but we need to make sure we can harness it effectively to focus on the cancer and avoid damage to the healthy tissues of the body. This is an area of intensive research, and every day we are learning more.”

The researchers now plan to carry out further studies of the two drugs, and follow patients on the existing trial for longer to understand more about the treatment. 

Study leader Dr Stephen Hodi, director of the Melanoma Center at Dana-Farber Cancer Institute, said: “Following up with patients in the current study over a longer period of time is an important step.”

This study was funded by Bristol-Myers Squibb, who make both drugs.

References

  • Postow, M., et al. (2015). Nivolumab and Ipilimumab versus Ipilimumab in Untreated Melanoma. New England Journal of Medicine. DOI: 10.1056/NEJMoa1414428