Sequential immunotherapy regimens - expect the unexpected
Mené sur 140 patients atteints d'un mélanome de stade avancé, cet essai randomisé de phase II compare la toxicité, du point de vue de la fréquence d'événements indésirables de grade 3-5, et l'efficacité de deux modalités d'administration séquentielle du nivolumab et de l'ipilimumab, le premier avant le second ou l'inverse
Immune checkpoint inhibitors have revolutionised the treatment of advanced melanoma, and have had a major impact on the treatment of other cancers. PD-1 inhibitors (nivolumab and pembrolizumab) are well tolerated and associated with grade 3–4 adverse events in 10–15% of patients, between 36–44% of patients achieving an overall response, and 73–74% of patients achieving 1-year survival. Combination therapy with ipilimumab and nivolumab, now also a standard of care, is associated with significantly higher proportions of patients achieving a response and progression-free survival, but is also associated with grade 3–4 adverse events in more than 50% of patients.