Dr. Luke Discusses the Controversy Surrounding Ipilimumab/Nivolumab Combo in Melanoma

Jason J. Luke, MD, assistant professor of Medicine, The University of Chicago Medicine, discusses the controversy surrounding the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) in treatment-naïve patients with advanced melanoma, which was explored in the CheckMate-067 trial, during the AACR Annual Meeting.

The combination gained regulatory approval based on response rate and progression-free survival, with the assumption that those results would translate to overall survival (OS), Luke explains. Results of the CheckMate-067 study, reported at AACR, confirmed there was a 12% improvement in OS, however, there is still a question of whether the OS improvement justifies the extreme increase in toxicity with the addition of ipilimumab, relative to PD-1 monotherapy.

While doctors continue to have differing opinions on the subject, Luke says his group is interested in exploring how to maximize benefit and minimize toxicity. One possible way to do this is with IDO inhibitor combinations, Luke says, for example, leading in with a PD-1 combination with high efficacy and low toxicity, and then using a CTLA-4 or ipilimumab-based regimen in the second-line setting if a patient progresses.