A diagnosis of melanoma is bad enough. Unfortunately, folks with mucosal melanoma have an even more difficult time. Here's a review of two articles:
This report (Jan 2017): Evaluation of response to nivo or ipi/nivo in Cutaneous and Mucosal Melanoma Notes ~ 889 patients who received nivolumab monotherapy in clinical studies, including phase III trials; 86 (10%) had mucosal melanoma and 665 (75%) had cutaneous melanoma. Data were also pooled for patients who received nivolumab combined with ipilimumab (n = 35, mucosal melanoma; n = 326, cutaneous melanoma). Among patients who received nivolumab monotherapy, median progression-free survival was 3.0 months and 6.2 months for mucosal and cutaneous melanoma, with objective response rates of 23.3% and 40.9%, respectively. Median progression-free survival in patients treated with nivolumab combined with ipilimumab was 5.9 months and 11.7 months for mucosal and cutaneous melanoma, with objective response rates of 37.1% and 60.4%, respectively.
So...according to these studies: Folks with mucosal melanoma who were given nivo alone had an objective response rate of 23% (cutaneous melanoma = 40%). Those with mucosal melanoma given the ipi/nivo combo had a 37% objective response rate (cutaneous = 60%). With pembro, folks with mucosal mel not previously treated with ipi the ORR was 19%. Those with prior ipi had a response rate of 15% to pembro. (Generally the ORR of patients with cutaneous mel treated with pembro was 33%.)
In the end, folks with cutaneous melanoma can respond to nivo (Opdivo) or pembro (Keytruda) alone (and those responses can be durable). However, it seems the response rate to the ipi/nivo combo is much better...though none of the response rates are as high as those that can be attained for cutaneous melanoma patients. Hang in there, ratties. Wishing you all my best. - c