Nivolumab alone or with ipilimumab in mucosal melanoma: pooled analysis
Pooling several trials showed that mucosal melanoma responds to nivolumab less often than skin melanoma, but that adding ipilimumab raised the response rate from about a quarter to more than a third, supporting combination immunotherapy first.
Overview
Pooled analysis of 889 patients from six nivolumab trials, including 86 with mucosal melanoma treated with nivolumab monotherapy and 35 with nivolumab plus ipilimumab, compared with 665 and 326 cutaneous melanoma patients.
In mucosal melanoma, objective response was 23.3 percent with nivolumab and 37.1 percent with the combination (versus 40.9 and 60.4 percent in cutaneous melanoma), with median progression-free survival 3.0 versus 5.9 months.
- Mucosal melanoma objective response 23.3 percent (nivolumab) vs 37.1 percent (nivolumab plus ipilimumab).
- Median progression-free survival 3.0 vs 5.9 months.
Nivolumab plus ipilimumab is the preferred first-line immunotherapy for mucosal melanoma where tolerated, given its lower intrinsic sensitivity to single-agent PD-1 blockade.
- Retrospective pooled analysis with small mucosal cohorts.
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