Innovative Immunotherapy Stopped Melanoma Progression

A new study in The New England Journal of Medicine reported the combination of 2 immunotherapy drugs, ipilimumab, and nivolumab has stopped or reversed the progression of advanced melanoma for five years or more, in about 50 percent of study participants.

According to this study published on September 28, 2019, the ‘Checkmate 067’ results represent the longest phase 3 clinical trial follow-up for checkpoint inhibitor combination therapy.

The trial saw 945 patients with advanced melanoma. The 5-year overall survival rate for the combination of nivolumab plus ipilimumab was 52 percent, with 74% of those patients treatment-free after 5-years. 

The overall survival for nivolumab was 44 percent, and 26 percent for ipilimumab.

One of the key points about immunotherapies is that the immune system can be re-educated even with a short duration of treatment. 

This is in contrast to other treatments like chemotherapy which can require a full course to be as effective, said these researchers.

Professor James Larkin, Ph.D., a Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust and Professor at the Institute of Cancer Research (ICR), said in a related press release, "In the past, oncologists considered melanoma different to other cancers - it couldn't be treated once it had spread.”

“This is the 1st  time we can say that the chances of being a long-term survivor of advanced melanoma are now over 50 percent, which is a huge milestone."

Prof Larkin says: "By giving these drugs together you are effectively taking 2 brakes off the immune system, rather than 1 so that the immune system is able to recognize tumors it wasn't previously and react to that and destroy them."

Importantly, for those patients who stopped treatment because of side-effects, the outcome was just as good as it was for those who were on the combination for longer.

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Skin cancer is the most common form of cancer in the United States, says the Centers for Disease Control and Prevention (CDC). 

The 2 most common types of skin cancer—basal cell and squamous cell carcinomas—are highly curable, but can be disfiguring and costly to treat.

More than 90 percent of melanoma skin cancers are due to skin cell damage from ultraviolet (UV) radiation exposure. 

UV rays are an invisible kind of radiation that comes from the sun, tanning beds, and sunlamps. UV rays can penetrate and damage skin cells.

The 3 types of UV rays are ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC), which are:

• Most UV rays that reach the surface of the earth are UVA rays. UVA rays can reach deep into human skin and damage connective tissue and the skin’s DNA.
• Most UVB rays are absorbed by the ozone layer, so fewer of them reach the earth’s surface compared to UVA rays. UVB rays, which help produce vitamin D in the skin, don’t reach as far into the skin as UVA rays, but they can still cause sunburn and damage DNA.
• UVC rays are very dangerous, but they are absorbed completely by the ozone layer and do not reach the earth’s surface.

In addition to causing sunburn, too much exposure to UV rays can change skin texture, cause the skin to age prematurely, and can lead to skin cancer. UV rays also have been linked to eye conditions such as cataracts, says the CDC.

Melanoma is the 3rd most common skin cancer, is more dangerous and causes the most deaths. Melanoma begins in the melanocytes, which are the cells that make melanin, the pigment that gives skin its color.

In 2016, the latest year for which incidence data are available, 82,476 new cases of melanomas of the skin and 8,188 related fatalities were reported in the USA. 

Immunotherapy research at The Royal Marsden is supported by The Royal Marsden Cancer Charity. The Checkmate 067 trial is funded by Bristol-Myers Squibb.

For further information please contact Francesca Vitale, Senior PR & Communications Officer at The Royal Marsden on [email protected] or 0207 808 2605

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