Dr. Jeffery S. Weber on Sequencing of Nivolumab, Ipilimumab in Metastatic Melanoma

Jeffery S. Weber, MD, PhD, deputy director of the Laura and Isaac Perlmutter Cancer Center, co-director of the Melanoma Program, and head of Experimental Therapeutics at NYU Langone Medical Center, discuses the key takeaways from the phase II CheckMate-064 trial, in which patients were randomized to receive either nivolumab followed by ipilimumab followed by nivolumab maintenance therapy, or ipilimumab followed by nivolumab and maintenance therapy with nivolumab.

The study found that there was not a big difference in toxicity between either arm and that the toxicities seen in both arms were very similar to concurrent therapy. The toxicity of ipilimumab/ nivolumab could not be reduced by giving the agents concurrently.

This reinforces the opinion of many investigators in the field that patients should go with nivolumab first and then, switch to ipilimumab if they need to, says Weber. However, there is no advantage of doing that over concurrent therapy in terms of toxicity.