Advanced melanoma: Dual drugs increase survival of ‘untreatable’ cancer – study

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By Sky News

A decade ago, only one in 20 sufferers would survive for five years, with many living for just six to nine months.

Patients with a skin cancer once thought untreatable can see their survival chances increase by 50% with a dual drug cocktail, a study indicates.

A medical trial has suggested that taken together, ipilimumab, which is marketed as Yervoy, and nivolumab, known as Opdivo, are more effective in stopping or reversing the progression of advanced melanoma.

Both drugs help the immune system to find and destroy cancer cells as they spread.

Professor James Larkin, consultant medical oncologist at the Royal Marsden NHS Foundation Trust and a professor at the Institute of Cancer Research, said: “By giving these drugs together you are effectively taking two brakes off the immune system rather than one so that the immune system is able to recognise tumours it wasn’t previously recognising and react to that and destroy them.”

The treatment is recommended by National Institute for Health and Care Excellence and is available in this combined way on the NHS, following assessments by doctors.

A decade ago, only one in 20 patients with advanced melanoma would survive for five years, with many living for just six to nine months.

Prof Larkin said: “In the past, metastatic melanoma was regarded as untreatable.

“Oncologists considered melanoma different to other cancers – it couldn’t be treated once it had spread.

“This is the first time we can say that the chances of being a long-term survivor of advanced melanoma are now over 50%, which is a huge milestone.”

Patients taking part in the trial were split into three groups.

The first with 314 participants were given both drugs.

Another group of 316 were given Opdivo with a placebo, while 315 people had Yervoy and a placebo

Overall survival for the Yervoy and Opdivo groups was 44% and 26% respectively.

This compared to a 52% five-year survival rate for the combination group.

Of those patients, 74% went treatment-free after five years – and the outcome was just as good for people who stopped treatment early because of side-effects such as skin rashes, diarrhoea and fatigue.

However, Prof Larkin pointed out there is currently no method to predict which patients are most likely to benefit from combination immunotherapy.

He said: “The two drugs together definitely have a role in treating metastatic melanoma and will be the choice for some patients. For others, the decision may be to give the drugs in sequence.”

Melanoma accounts for around 2,300 deaths in the UK every year. Around 16,000 people were diagnosed with the disease in 2016, the most recent figures available.

The findings of the trial will be presented at the European Society for Medical Oncology meeting in Barcelona, Spain, and published in The New England Journal of Medicine.