Dr. Kirkwood on the Use of Ipilimumab/Nivolumab in Melanoma With Brain Metastases

John M. Kirkwood, MD, director, the Melanoma Center, UPMC Hillman Cancer Center, professor of Medicine, Dermatology, and Clinical and Translational Ccience, the University of Pittsburgh School of Medicine, the Clinical and Translational Science Institute, the University of Pittsburgh, discusses the utilization of ipilimumab (Yervoy) and nivolumab (Opdivo) in patients with melanoma with brain metastases.

Since the conventional dose of 3 mg/kg of ipilimumab and 1 mg/kg of nivolumab has displayed efficacy in treating patients with melanoma who have brain metastases, it is vital to provide supportive care to these patients for toxicities associated with this combination, Kirkwood said. Although flip-dose regimens of 1 mg/kg of ipilimumab and 3 mg/kg of nivolumab have gained favor in practice around the world, it remains unclear if this regimen provides a benefit for patients with brain metastases, Kirkwood notes.

In March 2022, the FDA approved the combination of relatlimab and nivolumab (Opdualag) in the treatment of patients with unresectable or metastatic melanoma. However, the benefits of this combination in patients with melanoma with brain metastases have yet to be demonstrated, leaving the conventional dose of ipilimumab and nivolumab as the preferred option for this subgroup, Kirkwood concludes.