Skip to main content
Top

04-02-2025 | Melanoma | News

Limited intracranial response to nivolumab–ipilimumab after progression on anti-PD-1 therapy

Author: Dr. Shreeya Nanda

print
PRINT
insite
SEARCH

medwireNews: Among individuals with melanoma brain metastases (MBMs) who have received prior PD-1 inhibitor therapy, treatment with nivolumab plus ipilimumab achieves an intracranial response in about one in 10, indicate findings.

“Local therapies, particularly radiotherapy, therefore, may be critical for these patients,” say Michael Postow and colleagues from Memorial Sloan Kettering Cancer Center in New York, USA, in a research letter published in JAMA Oncology.

Outlining the rationale for the study, they explain that although intracranial response rates to nivolumab plus ipilimumab range from 44% to 54% among patients who have no prior exposure to anti-PD-1 therapy, the efficacy of the combination in those with such exposure “remains unknown.”

The team continue: “With increasing use of neoadjuvant and adjuvant anti-PD-1 therapy and high incidence of MBMs, clinicians will frequently encounter the challenge of managing MBMs in patients with prior anti-PD-1 exposure.”

To address this, the researchers identified 28 patients (61% men) who received nivolumab–ipilimumab at their institution between January 2011 and December 2023 for one or more progressive MBMs of at least 5 mm in size. The participants were aged a mean of 64 years and the majority (64%) had previously received anti-PD-1 monotherapy, while 36% had additionally received ipilimumab, but none had received local therapy for MBMs.

Following treatment with nivolumab plus ipilimumab, and a median follow-up of 7 months, the intracranial objective response rate was 11%, comprising two complete responses and one partial response.

“Both patients with [complete response] had 2 or fewer intracranial lesions, had no prior ipilimumab exposure, and remained alive and intracranial- and extracranial-progression free with 3 and 28 months of follow-up as of data cutoff,” note Postow and associates.

Stable disease was the best intracranial response in 18%, but stability did not last more than 6 months in any of these patients, and71% of patients had intracranial progressive disease.

The median duration of intracranial progression-free survival was 1.6 months, and median overall survival was 6.7 months.

Postow et al say that “[t]he study’s modestly sized, single-center patient population limits definitive conclusions, especially around whether prior ipilimumab in some patients affected subsequent ipilimumab-nivolumab effectiveness.”

And they conclude: “This study also emphasizes the need for larger studies and clinical trials to improve therapies for patients with anti–PD-1–resistant progressive MBM.

“This question will be increasingly relevant with increasing use of adjuvant and neoadjuvant anti–PD-1 therapy in melanoma and other cancers.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2025 Springer Healthcare Ltd, part of the Springer Nature Group

JAMA Oncol 2025; doi:10.1001/jamaoncol.2024.6168

print
PRINT

Related topics

ASH 2024 Annual Meeting Coverage

inMIND supports tafasitamab addition in follicular lymphoma

Combining tafasitamab with lenalidomide and rituximab significantly improves progression-free survival for patients with relapsed or refractory follicular lymphoma.

Featuring the official presentation video

Read more
SPONSORED

Recent advances in the use of CAR T-cell therapies in relapsed/refractory diffuse large B-cell lymphoma and follicular lymphoma

In this webinar, Professor Martin Dreyling and an esteemed international panel of CAR T-cell therapy experts discuss the latest data on the safety, efficacy, and clinical impact of CAR T-cell therapies in the treatment of r/r DLBCL and r/r FL.

Please note, this webinar is not intended for healthcare professionals based in the US and UK.

Sponsored by:
  • Novartis Pharma AG
Chaired by: Prof. Martin Dreyling
Developed by: Springer Healthcare
Watch now