Seven year follow-up of the phase 3 KEYNOTE-006 trial: pembrolizuamb versus ipimimumab in advanced melanoma

Immune checkpoint inhibitors have improved the overall survival (OS) of patients with advanced melanoma. The multinational phase 3 KEYNOTE-006 trial randomized patients with advanced melanoma to pembrolizumab or ipilimumab. At median 85.3 months follow-up the median OS was 32.7 months with pembrolizumab versus 15.9 months with ipilimumab; the seven-year OS rate was 37.8% versus 25.3%, respectively. The median progression-free survival PFS) was 9.4 months with pembrolizumab versus 3.8 months with ipilimumab; the seven-year PFS rate was 23.8% versus 13.3%, respectively. The OS benefit with pembrolizumab over ipilimumab was seen regardless of BRAF status or prior BRAF/MEK-inhibitor treatment. In patients who completed at least 94 weeks of pembrolizumab, the five-year OS rate was 92.9% and the five-year PFS rate was 70.1%. The authors conclude that these findings confirm that pembrolizumab provides long-term survival benefit in advanced melanoma.