Improved overall survival in dual compared to single immune checkpoint inhibitors in BRAF V600-negative advanced melanoma

Adi Kartolo; Cynthia Yeung; Markus Kuksis; Wilma Hopman; Tara Baetz

doi:10.2217/mmt-2021-0005

Improved overall survival in dual compared to single immune checkpoint inhibitors in BRAF V600-negative advanced melanoma

Melanoma Manag. 2022 Apr 26;9(1):MMT60. doi: 10.2217/mmt-2021-0005. eCollection 2022 Apr.

Authors

Adi Kartolo¹, Cynthia Yeung¹, Markus Kuksis¹, Wilma Hopman¹, Tara Baetz¹

Affiliation

¹ Cancer Centre of SouthEastern Ontario, Kingston Health Sciences Centre, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.

Abstract

Aim: To evaluate the efficacy of dual versus single immune checkpoint inhibitors (ICI) in BRAF wild-type advanced melanoma patients.

Materials & methods: A retrospective study of all advanced BRAF wild-type melanoma patients on palliative-intent ICI between 2015 and 2020 (n = 67).

Results: Dual ICI had better overall survival (OS) when compared with single ICI in BRAF wild-type patients (hazard ratio: 0.204; 95% CI: 0.064-0.649; p = 0.007), but lost its statistical significance (median OSl not reached vs 20.9 months; p = 0.213; adjusted hazard ratio: 0.475; 95% CI: 0.164-1.380; p = 0.171) when only including patients treated after 2018 when dual ICI was funded in our province. Dual ICI were significantly associated with more frequent (p = 0.005) and severe (p = 0.026) immune-related adverse events, and required more immune-related adverse events-indicated systemic corticosteroid use (p < 0.001) compared with single ICI.

Conclusion: While limited by small sample size and retrospective nature, dual ICI may have non statistically significant trend toward better OS efficacy when compared with single ICI in BRAF V600 wild-type advanced melanoma patients.

Keywords: BRAF V600 negative; immune checkpoint inhibitor; immunotherapy; melanoma; metastatic.