Long-term findings from a significant international study indicate that nearly 50% of patients with metastatic melanoma who received a combination of immune checkpoint inhibitors remain free of cancer for 10 years or longer, as reported by researchers from Weill Cornell Medicine and Dana-Farber Cancer Center.
Recent long-term findings from an important international trial reveal that roughly half of the patients suffering from metastatic melanoma and treated with a combination of immune checkpoint inhibitors are cancer-free for a decade or more, according to a report by investigators from Weill Cornell Medicine and Dana-Farber Cancer Center.
The 10-year follow-up research, published on September 15 in the New England Journal of Medicine, concludes the phase 3 CheckMate 067 trial. This trial involved 945 patients from 137 locations across 21 countries and showed that using nivolumab and ipilimumab—two immunotherapies that block different immune checkpoint proteins—significantly enhanced the outcomes for a malignancy that was once almost always fatal. Additional assessments of patient outcomes at 3, 5, and 6.5 years post-trial initiation revealed that the positive results continued for several years among those who responded to the treatment.
“This trial has been transformative for medical practice,” stated Dr. Jedd Wolchok, the Meyer Director of the Sandra and Edward Meyer Cancer Center and a professor of medicine at Weill Cornell Medicine, who is also an oncologist at NewYork-Presbyterian/Weill Cornell Medical Center. “The average survival for this patient group is now just over six years, and those who are cancer-free after three years have a high probability of remaining alive and disease-free at the 10-year mark.”
Back in 2011, the average survival for metastatic melanoma patients was only six and a half months. However, the introduction of immune checkpoint inhibitors, which enhance the immune system’s ability to combat cancer, gradually led to improved survival rates. The CheckMate 067 trial illustrated that nivolumab, when used alone or alongside ipilimumab, offers a more effective treatment method compared to ipilimumab on its own.
“This trial plays a crucial role in how we inform patients about the long-lasting benefits of immune checkpoint therapy and the potential of using various immune treatments in combination to enhance results,” remarked Dr. F. Stephen Hodi, director of the Melanoma Center and the Center for Immuno-Oncology at Dana-Farber, who is a co-senior author of the study alongside Dr. James Larkin of The Royal Marsden Hospital in the UK.
Along with confirming that approximately half of the patients treated with the combination therapy survive long-term, the 10-year analysis revealed no new safety concerns regarding treatment. Some doctors had expressed fears that health issues linked to treatment might arise later since patients must take the medications over an extended period. However, the 10-year review indicated no alarming signs of long-term side effects, with no significant resurgence of previously noted acute toxicities and only a few melanoma recurrences.
The research team evaluated melanoma-specific survival and overall survival at the 10-year mark and found that these two outcomes diverge over time, indicating that as metastatic melanoma survivors age, they become more likely to die from other causes—a sign of effective long-term treatment, according to the researchers.
“After a decade of monitoring, we can now assure our patients that there are treatments available that can turn metastatic melanoma into a manageable, long-term condition, thus fostering hope for the future,” said Dr. Hodi.
In addition to showcasing a reassuring long-term safety and efficacy profile for this combination of immune checkpoint inhibitors, the researchers aim to enhance care protocols for those surviving metastatic melanoma. The findings imply that patients who remain healthy at three or five years are likely to continue in good health, which may allow healthcare providers to lessen the frequency of follow-up visits or testing, they noted.
These extensive data from the CheckMate 067 trial could assist patients with metastatic melanoma in understanding their prognosis. Dr. Wolchok pointed out that patients often feel understandably distressed or anxious upon learning their cancer has spread.
“We strive to help them adopt a mindset of hope and more positive expectations,” he explained. “We can now confidently state that half of the patients who undergo this combination therapy will live for 10 years or more without the fear of dying from metastatic melanoma.”
Dr. Jedd Wolchok is a compensated consultant for Bristol Myers Fund, Inc.
This research was supported by Bristol Myers Squibb (Princeton, NJ, USA), a grant (P30CA008748) from the National Cancer Institute, part of the National Institutes of Health; and a grant from the National Institute for Health Research Royal Marsden-Institute of Cancer Research Biomedical Research Centre.
