Friday, March 20, 2015

Nivo (Opdivo) effectiveness in melanoma - NO BRAF positive status needed

When ipi naive melanoma patients are given Nivolumab (or Pembrolizumab for that matter), there is roughly a 40% response rate in patients irregardless of BRAF status.

This was reported at ASCO, June 2014:
Survival, response duration, and activity by BRAF mutation status of nivolumab (anti-PD1, BMS-936588) and ipilimumab concurrent therapy in advanced melanoma
Abstract LBA9003, Sznol, Kluger, Kirkwood, Wolchok, et al

53 melanoma patients were enrolled from 2009-2012 and were given ipi and nivo concurrently, then followed by nivo alone (with a variety of dosing patterns). Patients with and without BRAF had similar response.

Nivolumab in previously untreated melanoma without BRAF mutation.  Robert, Long, Brady, et al. N Engl J Med, November 2014.

418 previously untreated patients without the BRAF mutation were randomly assigned to Nivolumab (Opdivo) at 3mg/kg every 2 weeks or dacarbazine every three weeks.  At 1 year, the overall survival rate was 72.9% in the nivo group vs 42% in the dacarbazine group.  Median progression free survival was 5.1 months for the nivo group vs 2.2 months for dacarbazine.  Objective response was 40% for nivo vs 13.9% for dacarbazine.

Good enough.  BRAF status makes no difference in your response rate to Nivo.  Now STOP giving people dacarbazine!!!!! They really are people...not just ratties!! - c

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