Optimum treatment for advanced melanoma patients revealed
Researchers now have greater clarity on the best course of treatment for patients with advanced melanoma which has spread to the brain, following a clinical trial run by Melanoma Institute Australia.
Typically, patients with active brain metastases survive only four to five months and never even used to be admitted to clinical trials because their prognosis was so dire. The Anti-PD1 Brain Collaboration (ABC) trial sought to change this, with participants given either a combination of two immunotherapy drugs (nivolumab and ipilimumab) or single therapy (nivolumab alone).
Published in The Lancet Oncology, the phase II trial suggests that patients with asymptomatic brain metastases have a good chance of long-term response to treatment, with 46% of those treated with the combination immunotherapy still alive after 17 months — compared to 20% in patients who received nivolumab alone. The results were even better in patients who had not received any prior targeted therapy (eg, MEK or BRAF inhibitors), with 56% of these patients achieving an overall response rate.
“This research will be used to change the way we treat patients who come to us with brain metastases,” said Professor Georgina Long, the study’s chief investigator. “Our findings suggest that our first treatment option for these patients should be giving this combination of immunotherapies instead of targeted therapy.”
Furthermore, the researchers found they could halt disease progression in some patients. In 17% of patients receiving the combination treatment, melanoma completely disappeared from their brain.
“This research should give hope to melanoma patients,” said Professor Long. “It means that having brain metastases is no longer a death sentence for some patients.”
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