Immune checkpoint inhibitors such as PD-1 inhibitors and antibodies to CTLA-4 provide much better survival rates for patients with advanced melanoma. Important developments have included the approval of ipilimumab, an anti-CTLA-4 agent, and the PD-1 inhibitors nivolumab and pembrolizumab. The phase 3 CheckMate 067 trial showed that after at least 7.5 years, the median overall survival for patients with advanced melanoma was 72 months with nivolumab plus ipilimumab. The trial highlighted new clinical questions about the longer survival, such as overall and melanoma-specific survival, long-term outcomes for those who were progression free at 3 years, and progression patterns. This year, an important extended follow-up was published in The New England Journal of Medicine.

Jedd D. Wolchok et al. reported 10 years of follow-up from the CheckMate 067 trial, confirming that overall survival and melanoma-specific survival were longer with nivolumab plus ipilimumab or with nivolumab alone than with ipilimumab alone. The combination treatment showed the longest overall survival (71.9 months), relative to that with nivolumab (36.9 months) or ipilimumab (19.9 months). Median melanoma-specific survival was also longer with the combination (exceeding 120 months) than with nivolumab (49.4 months) or ipilimumab (21.9 months).