Clinical Trials
Nivolumab continues to be studied for safety and efficacy in a variety of cancers, which includes monitoring patients after completion of therapy. Melanoma trials include phase I studies investigating nivolumab combined with peptide vaccines to observe objective response and time to relapse in patients with resected stage IIIC or IV melanoma. Phase III studies are underway to compare the overall survival and objective response of nivolumab with those of dacarbazine, carboplatin, and paclitaxel. Overall survival rates for nivolumab versus ipilimumab alone or in combination is the objective for another phase III study (Merelli et al., 2014).
Nivolumab has been found to be more tumor specific and less toxic than some other immunotherapies, possibly because it reactivates T lymphocytes in the circulation and the tumor rather than activating T cells in the lymph nodes throughout the body (Merelli et al., 2014). Partial sustained responses to nivolumab were noted for more than one year in patients with advanced melanoma, prostate cancer, non-small cell lung cancer, renal cell carcinoma, and colorectal cancer (Lipson, 2013), with a median duration of response in melanoma of more than two years (Merelli et al., 2014). The overall response rate was 28% in melanoma (Menzies & Long, 2013), compared to 11% with ipilimumab (Bristol-Myers Squibb, 2013) and 40% when the drugs were combined (Merelli et al., 2014).