Adjuvant nivolumab versus ipilimumab after complete resection of stage III or IV melanoma: five-year results of CheckMate 238

The multinational phase 3 CheckMate 238 trial randomized patients after resection of stage IIIB, IIIC, or IV melanoma to adjuvant nivolumab or ipilimumab. At a minimum follow-up of 62 months, the recurrence-free survival remained superior with nivolumab versus ipilimumab (5-year rates 50% versus 39%; HR 0.72; 95% CI 0.60-0.86). Five-year distant metastasis-free survival rates were 58% with nivolumab versus 51% with ipilimumab. Five-year overall survival rates were 76% with nivolumab versus 72% with ipilimumab (75% data maturity). The authors conclude that nivolumab is a proven adjuvant treatment for resected melanoma at high risk of recurrence. Identification of additional biomarkers is needed to better predict treatment outcome.