WEDNESDAY, June 5, 2024 (HealthDay News) -- Neoadjuvant ipilimumab plus nivolumab followed by surgery results in longer event-free survival than surgery followed by adjuvant nivolumab among patients with resectable, macroscopic stage III melanoma, according to a study published online June 2 in the New England Journal of Medicine to coincide with the annual meeting of the American Society of Clinical Oncology, held from May 31 to June 4 in Chicago.
Christian U. Blank, M.D., Ph.D., from the Netherlands Cancer Institute in Amsterdam, and colleagues randomly assigned 423 patients with resectable, macroscopic stage III melanoma to receive two cycles of neoadjuvant ipilimumab plus nivolumab and then undergo surgery or to undergo surgery and then receive 12 cycles of adjuvant nivolumab in a 1:1 ratio.
The researchers found that the estimated 12-month event-free survival was 83.7 and 57.2 percent in the neoadjuvant and adjuvant groups, respectively, at a median follow-up of 9.9 months. There was an eight-month difference in restricted mean survival (hazard ratio for progression, recurrence, or death, 0.32). In the neoadjuvant group, 59.0, 8.0, 26.4, and 2.4 percent of patients had a major pathological response, partial response, nonresponse, and progression, respectively; surgery had not yet been performed or was omitted in 4.2 percent. The estimated 12-month recurrence-free survival was 95.1, 76.1, and 57.0 percent among patients in the neoadjuvant group with a major pathological response, partial response, and nonresponse, respectively.
"Two cycles of neoadjuvant ipilimumab plus nivolumab was safe and resulted in longer event-free survival than adjuvant nivolumab among patients with resectable, macroscopic stage III melanoma," the authors write.
The study was funded in part by Bristol Myers Squibb, the manufacturer of ipilimumab and nivolumab.
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