Applications for Clinical Practice
In this well-designed and -executed multicenter randomized trial, funded by Bristol-Myers Squibb and implemented in a selected population with good performance status, all 3 immunotherapies demonstrated impressive improvements in the management of advanced melanoma. The combination nivolumab and ipilimumab was the most effective, with markedly higher survival and response rates, but also with higher toxicity requiring treatment discontinuation, though this did not decrease the efficacy of the therapy. Both the combination nivolumab plus ipilimumab and nivolimab alone are acceptable treatments for patients with advanced melanoma and good performance status; cost and comorbidities will be critical in personalizing therapy.
—Matthew Painschab, MD, University of North Carolina, Chapel Hill, NC