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Combination of nivolumab and relatlimab remains effective in slowing the growth of advanced melanoma

Posted on March 19, 2022

Who does this study affect:

People with untreated advanced melanoma

What did this study find:

What did this study find: A new report from the global phase II/III RELATIVITY-047 clinical trialshows that a combination of the immunotherapy drugs relatlimab and nivolumab (Opdivo) remains effective in slowing the growth of untreated advanced melanoma. The combination treatment may also shrink the melanoma and help people with this disease live longer compared with nivolumab alone.

Immunotherapy is a type of cancer treatment that boosts the body’s natural defenses to fight cancer. Nivolumab is a PD-1 immune checkpoint inhibitor that helps the body’s immune system target and destroy melanoma cells. Relatlimab is a type of immunotherapy that targets the lymphocyte-activation gene 3 (LAG-3). The LAG-3 gene controls a pathway that reduces the function of immune cells called T cells. Relatlimab releases the limits put on T cells by LAG-3. In this study, the researchers wanted to find out if targeting both PD-1 and LAG-3 pathways at the same time could slow or stop the growth of the melanoma, shrink the cancer, and help patients live longer.

This study included 714 people from around the world with untreated melanoma that was either metastatic or could not be treated with surgery. Of the participants, 355 received the combination of relatlimab with nivolumab, and 359 received nivolumab alone. The median follow-up was just over 19 months. The median is the midpoint, meaning half of the people were followed for fewer than 19 months and the other half were followed for more than 19 months.

The study found that, in keeping with earlier results, the combination treatment slowed or stopped the cancer from growing for a median of 10.2 months, which is more than twice as long as for nivolumab alone, which was 4.6 months. The combination treatment may also help patients live longer. At 12 months, 77% of people receiving the combination treatment were still alive, compared with nearly 72% of those receiving nivolumab alone. At 24 months, nearly 64% of those receiving the combination were still alive, compared with about 58% of those receiving nivolumab.

More participants in the combination group also had their melanoma shrink or had no signs of melanoma in response to treatment. The overall response rate, which is the percentage of participants whose tumors shrank, was about 43% in the combination group compared with nearly 33% in the nivolumab alone group. Meanwhile, just over 16% of participants in the combination group had no signs of melanoma after treatment, compared with about 14% in the nivolumab alone group.

The combination treatment did cause more side effects, including serious side effects. Among those receiving the combination treatment, just over 1 in 5 experienced a serious side effect (21.1%), and 4 people died related to the treatment in this group. Of the participants who received nivolumab alone, just over 1 in 10 experienced a serious side effect (11.1%), and 2 people died related to the treatment. Side effects of any severity caused about 15% of people to stop receiving the combination treatment and about 7% of people to stop receiving nivolumab alone.

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