Safe Stop IPI-NIVO trial: early discontinuation of nivolumab upon achieving a complete or partial response in patients with irresectable stage III or metastatic melanoma treated with first-line ipilimumab-nivolumab – study protocol

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Title: Safe Stop IPI-NIVO trial: early discontinuation of nivolumab upon achieving a complete or partial response in patients with irresectable stage III or metastatic melanoma treated with first-line ipilimumab-nivolumab – study protocol
Authors: J. C. Janssen, B. van Dijk, K. de Joode, M. J. B. Aarts, F. W. P. J. van den Berkmortel, C. U. Blank, M. J. Boers-Sonderen, A. J. M. van den Eertwegh, J. W. B. de Groot, M. Jalving, M. J. A. de Jonge, A. Joosse, E. Kapiteijn, A. M. Kamphuis-Huismans, K. A. T. Naipal, D. Piersma, B. Rikhof, H. M. Westgeest, G. Vreugdenhil, E. Oomen-de Hoop, E. E. A. P. Mulder, Astrid A. M. van der Veldt
Source: BMC Cancer, Vol 24, Iss 1, Pp 1-7 (2024)
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Melanoma, Ipilimumab, Nivolumab, Discontinuation of treatment, Immune checkpoint inhibitors, Treatment duration, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background Patients with irresectable stage III or metastatic melanoma presenting with poor prognostic factors are usually treated with a combination of immune checkpoint inhibitors (ICIs), consisting of ipilimumab and nivolumab. This combination therapy is associated with severe immune related adverse events (irAEs) in about 60% of patients. In current clinical practice, patients are usually treated with ICIs for up to two years or until disease progression or the occurrence of unacceptable AEs. The incidence of irAEs gradually increases with duration of treatment. While durable tumour responses have been observed after early discontinuation of treatment, no consensus has been reached on optimal treatment duration. The objective of the Safe Stop IPI-NIVO trial is to evaluate whether early discontinuation of ICIs is safe in patients with irresectable stage III or metastatic melanoma who are treated with combination therapy. Methods The Safe Stop IPI-NIVO trial is a nationwide, multicentre, prospective, single-arm, interventional study in the Netherlands. A total of 80 patients with irresectable stage III or metastatic melanoma who are treated with combination therapy of ipilimumab-nivolumab and have a complete or partial response (CR/PR) according to RECIST v1.1 will be included to early discontinue maintenance therapy with anti-PD-1. The primary endpoint is the rate of ongoing response at 12 months after start of ICI. Secondary endpoints include ongoing response at 24 months, disease control at different time points, melanoma specific and overall survival, the incidence of irAEs and health-related quality of life. Discussion From a medical, healthcare and economic perspective, overtreatment should be prevented and shorter treatment duration of ICIs is preferred. If early discontinuation of ICIs is safe for patients who are treated with the combination of ipilimumab-nivolumab, the treatment duration of nivolumab could be shortened in patients with a favourable tumour response. Trial registration ClinicalTrials.gov ID NCT05652673, registration date: 08–12-2022.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2407
Relation: https://doaj.org/toc/1471-2407
DOI: 10.1186/s12885-024-12336-0
Access URL: https://doaj.org/article/ca4c9e5c51fc40759d196932967e286e
Accession Number: edsdoj.4c9e5c51fc40759d196932967e286e
Database: Directory of Open Access Journals
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ISSN:14712407
DOI:10.1186/s12885-024-12336-0
Published in:BMC Cancer
Language:English