Nivolumab in metastatic melanoma: good efficacy and tolerability in elderly patients

  • R. De Luca University of Palermo
  • S. Meraviglia University of Palermo
  • L. Blasi ARNAS, Ospedali Civico Di Cristina Benfratelli
  • A. Maiorana University of Palermo
  • G. Cicero University of Palermo
Keywords: Opdivo, melanoma metastatic, elderly patients, immunotherapy, quality of life, clinical benefit, lactate dehydrogenase levels

Abstract

Background Nivolumab is an anti–PD-1 antibody that restores the antitumour immune function of T cells, blocking the binding of PD-1 with its ligand PD-L1. PD-1 is expressed on T cells and interacts with PD-L1 on tumour cells. The PD-1–PD-L1 link inhibits T cell activation. In metastatic melanoma, PD-1–PD-L1 binding plays a critical role, and the advent of the immune checkpoint inhibitor nivolumab has delivered new and effective treatment options with proven clinical benefit. In the present study, we evaluated the efficacy of nivolumab in elderly patients with metastatic melanoma.

Methods The study enrolled 55 elderly patients (75 years of age and older) with a diagnosis of metastatic melanoma. Primary endpoints of the study were progression-free survival (pfs) and the objective response rate; secondary endpoints were overall survival, reduction in serum lactate dehydrogenase (ldh) from before to after treatment, and tolerability.

Results Nivolumab was well tolerated and resulted in good disease control, with a manageable toxicity profile and significant clinical benefit. The duration of pfs was 5.1 months (95% confidence interval: 3.5 months to 6.8 months). A significant correlation was observed between reduction in serum ldh and pfs: 0.60 (95% confidence interval: 0.28 to 0.86; p = 0.002).

Conclusions Nivolumab is an immunotherapy treatment that has proved to be an effective and well-tolerated therapeutic option in elderly patients with metastatic melanoma.

Author Biographies

R. De Luca, University of Palermo

Department of Surgical, Oncological and Oral Sciences, Section of Surgical Oncology

S. Meraviglia, University of Palermo

Central Laboratory of Advanced Diagnosis and Biomedical Research

L. Blasi, ARNAS, Ospedali Civico Di Cristina Benfratelli

Medical Oncology Unit

A. Maiorana, University of Palermo

Department of Surgical, Oncological and Oral Sciences, Section of Surgical Oncology

G. Cicero, University of Palermo

Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology

Published
2019-10-18
How to Cite
De Luca, R., Meraviglia, S., Blasi, L., Maiorana, A., & Cicero, G. (2019). Nivolumab in metastatic melanoma: good efficacy and tolerability in elderly patients. Current Oncology, 27(2). Retrieved from https://current-oncology.com/index.php/oncology/article/view/5293
Section
Medical Oncology