Ipilimumab with or without anti-PD-1 therapy for metastatic melanoma resistant to anti-PD-(L)1 monotherapy

Anti-PD-1 therapy induces long-term disease control in approximately 30% of patients with metastatic melanoma. The other patients require further treatment. A multinational retrospective study compared ipilimumab alone versus ipilimumab plus anti-PD-1 therapy (pembrolizumab or nivolumab) for metastatic melanoma that was resistant to anti-PD-(L)1 monotherapy. The outcomes were better in the combination therapy group versus the monotherapy group in terms of ORR (31% versus 13%; p<0.0001), PFS (median 3.0 months versus 2.6 months; HR 0.69; p=0.0019), and OS (median 20.4 months versus 8.8 months; HR.0.50; p<0.0001). Grade 3-5 adverse events rates were similar.