Pembrolizumab is associated with better real-world 24-week quality of life (QoL) compared to the combination of ipilimumab plus nivolumab for advanced melanoma (Qual Life Res. 2020. doi:10.1007/s11136-020-02520-7).
Richard W Joseph, MD, Mayo Clinic, Rochester, Minnesota, and colleagues aimed to address limited health-related QoL real-world evidence with approved immunotherapies for patients with advanced melanoma.
Therefore, they conducted a prospective US observational study comparing QoL in patients with advanced melanoma receiving first-line pembrolizumab or ipilimumab plus nivolumab in clinical practice.
The study enrolled 412 patients initiating first-line pembrolizumab (n = 225) or ipilimumab plus nivolumab (n = 187) between June 2017 and March 2018.
The primary end points included QLQ-C30 global health score (GHS) and EuroQol visual analog scale (EQ-VAS) scores.
From baseline through week 24, pembrolizumab was associated with a mean GHS score increase of 3.2 (95% CI 0.5, 5.9; P = .02), while no change was observed with ipilimumab plus nivolumab (0.2; 95% CI − 2.6, 3.0; P = 0.87).
Among objective treatment-responders, GHS scores with pembrolizumab increased 6.0 (95% CI 3.1, 8.8; P <.0001) compared with an increase of 3.8 (95% CI 0.8, 6.9; P = .01) with ipilimumab plus nivolumab. Among treatment non-responders, ipilimumab plus nivolumab was associated with GHS score/QoL deterioration of −3.7 (95% CI −6.8, −0.6; P = .02), whereas pembrolizumab non-responders demonstrated no change; (0.7; 95% CI −2.3, 3.7; P = 0.6).
Additionally, between treatments, EQ-VAS increased 2.6 greater with pembrolizumab (95% CI 0.6, 4.5; P = .01) versus ipilimumab plus nivolumab at 24 weeks.
“[Pembrolizumab] was associated with better 24-week QoL compared to… [ipilimumab plus nivolumab] in actual clinical practice settings. Real-world data has known limitations, but with further confirmation these results may have implications for treatment selection,” Dr Joseph and colleagues concluded.—Janelle Bradley
