Affiliation: School of Medicine, Department of Allied Health Sciences, Physician Assistant Program
Purpose: Over the past 30 years, the incidence of melanoma has been climbing at a faster rate than any other malignancy. In 2019, it is projected that close to 100,000 new patients will be diagnosed with melanoma. Melanoma would then become the fifth most common type of cancer in the United States.1 With the advent of anti-PD-1 immunotherapies, such as pembrolizumab and nivolumab, an individual’s own immune system can now recognize and kill cancers, such as melanoma2. Immunotherapies bring a new and exciting approach to the treatment of melanoma and other forms of cancer. A review of the current state of clinical studies in the setting of metastatic melanoma treatment is therefore needed to understand better how progression-free survival and overall survival have been effected with the introduction of anti-PD-1 antibodies.
Materials and Methods: Five clinical research trials were selected for review based on the following criteria: use of either pembrolizumab or nivolumab as a monotherapy for patients with metastatic melanoma. The progression-free survival period and overall survival were determined and, where appropriate, compared to chemotherapy or the cytotoxic T-lymphocyte antigen-4 inhibitor, ipilimumab.
Results: Across the five clinical studies, pembrolizumab and nivolumab showed statistically significant improvement in progression-free survival and overall survival in three out of five studies. The two studies that did not find a statistical significance still showed a numerical improvement
Conclusion: Pembrolizumab and nivolumab, given as monotherapy, improve progression-free survival and overall survival when compared to chemotherapies and the immunotherapy, ipilimumab.