{"entity":{"id":"paper-checkmate-238-nejm-2017","kind":"paper","name":"CheckMate 238: adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma","aka":[],"tldr":"A year of adjuvant nivolumab after surgery for high-risk melanoma reduced recurrences more than the previous standard, high-dose ipilimumab, with a quarter of the severe toxicity, making PD-1 blockade the adjuvant standard.","summary":"Phase 3 trial of 906 patients with resected stage IIIB, IIIC or IV melanoma randomised to nivolumab or ipilimumab 10 mg/kg for one year.\n\nTwelve-month recurrence-free survival was 70.5 versus 60.8 percent (hazard ratio 0.65), with grade 3 to 4 treatment-related adverse events in 14.4 versus 45.9 percent; four-year recurrence-free survival was 51.7 versus 41.2 percent, with no overall survival difference.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2017","url":"https://doi.org/10.1056/NEJMoa1709030"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28891423/"}],"tags":[],"related":[],"cancers":["stage-iii-melanoma"],"sections":[],"technologies":[],"targets":[],"drugs":["ipilimumab","nivolumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["checkmate-238"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2017,"doi":"10.1056/NEJMoa1709030","pmid":"28891423","authors":"Weber J, Mandala M, Del Vecchio M, et al.","paperType":"rct","findings":["Twelve-month recurrence-free survival 70.5 percent vs 60.8 percent; hazard ratio 0.65.","Grade 3 to 4 adverse events 14.4 percent vs 45.9 percent."],"whatItMeans":"Adjuvant nivolumab (or pembrolizumab) is standard for resected stage III and IV melanoma; ipilimumab is no longer used in the adjuvant setting.","caveats":["No placebo arm; the comparison is against an active but toxic agent.","Overall survival did not differ, probably because of effective therapy at relapse."],"changedPractice":true,"participants":906},"route":"/key-papers/paper-checkmate-238-nejm-2017/","neighbours":{"cancer":[{"id":"stage-iii-melanoma","kind":"cancer","name":"Stage III melanoma (after surgery)","route":"/cancers/stage-iii-melanoma/"}],"drug":[{"id":"ipilimumab","kind":"drug","name":"Ipilimumab","route":"/drugs/ipilimumab/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"}],"trial":[{"id":"checkmate-238","kind":"trial","name":"CheckMate 238","route":"/trials/checkmate-238/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}