RE: Standard of Care19 Feb 2025 07:36
Re. the 'lay' link in 07.03 :-
""From just 16 weeks’ survival to long term disease control – new data confirms life-saving impact of breakthrough melanoma treatment.
Newly released long-term data from a groundbreaking clinical trial for advanced melanoma patients whose disease had spread to their brain has proven that long-term disease control has been achieved for over 50% of patients given combination immunotherapy as first line treatment.
The impressive 7-year follow up results from the ABC clinical trial were published today in the high impact journal Lancet Oncology.
Brain metastases are present in 30-40% of patients at diagnosis with Stage 4 (advanced) melanoma. In the past, these patients only survived for around 16 weeks.
The ABC trial was the first to demonstrate that these advanced melanoma patients could be successfully treated with combination immunotherapy using nivolumab and ipilimumab. So impressive were early survival rates from the trial, released in 2018, clinical practice changed virtually overnight.
‘The 7-year follow-up results released today show overall survival of 48% of patients on combination immunotherapy, with the survival rate increasing to 51% in patients given the treatment upfront. This proves we have achieved long-term disease control in this group of advanced melanoma patients,’ said Professor Georgina Long AO, Medical Director of Melanoma Institute Australia and lead author of the study.
‘We are now confident these patients are cured, a term not used lightly in cancer. This combination immunotherapy should now become standard of care for melanoma patients with brain metastasis,’ she said.
The randomized, phase 2 study was conducted at four sites in Australia – Melanoma Institute Australia, Princess Alexandra Hospital, Royal Adelaide Hospital and Peter MacCallum Cancer Centre.
Between 2014 and 2017, 79 patients were enrolled in the ABC trial, with 36 given combination checkpoint inhibitor immunotherapy (anti-PD-1 plus anti-CTLA-4) and 43 given single agent immunotherapy (nivolumab).
Initial results released in 2018 showed a 46% response rate for those patients given the combination immunotherapy, versus just 20% response rate for those on single agent immunotherapy.
The 7-year results, released today, show progression free survival rate was 42% with ipilimumab plus nivolumab, compared to 15% with nivolumab alone. Overall survival was 48% and 26% respectively.
In patients treated upfront, or as first line treatment, 7-year progression free survival rate was 47% with the combination immunotherapy and 14% with the single agent, with overall survival 51% and 29% respectively.
This is the longest follow-up ever for melanoma patients with active brain metastases. Results show that, if treated with this combination immunotherapy upfront, these patients can have similar outcomes to those melanoma patients without active brain disease.
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