Randomized trial compares efficacy and toxicity of ipilimumab–nivolumab dosing strategies in melanoma brain metastases, suggesting lower doses may be beneficial.
Key Points
This study aims to compare the efficacy and toxicity of different dosing strategies of ipilimumab and nivolumab in patients with melanoma brain metastases.
Retrospective analysis of patients with melanoma brain metastases treated with ipilimumab and nivolumab across three Mayo Clinic sites between 2016 and 2024.
Patients were categorized into two groups based on induction dosing: Ipi1+Nivo3 and Ipi3+Nivo1.
Overall survival and progression-free survival were estimated using the Kaplan–Meier method and compared using log-rank tests.
Median overall survival was 18.5 months with Ipi1+Nivo3 versus 10.6 months with Ipi3+Nivo1 (log-rank p=0.25).
Median progression-free survival was 7.3 months with Ipi1+Nivo3 versus 2.8 months with Ipi3+Nivo1 (log-rank p=0.16).
Neurologic adverse events occurred only with Ipi3+Nivo1 (11.9% vs 0% in Ipi1+Nivo3).