This article looked at the progress of two new drugs for advanced-stage melanoma that target the PD-1 receptor. They were recently approved by the FDA for treating patients with unresectable or metastatic melanoma. Pembrolizumab and nivolumab are antibodies that prevent the PD-1 receptor, a programmed cell death receptor, from interacting with its ligands by binding with the receptor. This allows the body to have a better anti-cancer immune response.
This is a breakthrough treatment option, because usually surgical resection is only possible in early-stage melanoma. Chemotherapy is the most common option for patients with advanced-stage unresectable melanoma. Other medication options offer only moderate benefit and significant toxicity. Immunotherapy is an effective treatment for melanoma and other cancers, and even though only about 20% of patients respond to this type of therapy, they usually have long-lasting responses. Adverse reactions experienced from PD-1 inhibitors can usually managed with corticosteroids.
Clinical trials tested the safety and efficacy of Pembrolizumab, and a Phase I open-label trial of 135 patients found that 38% showed an objective response and a progression-free survival time of at least 7 months. 79% of patients had an adverse reaction, but only 13% had a serious adverse reaction. The cost of a single dose for a 70 kg patient is estimated to be $7500, and it is administered via IV every 3 weeks.
Clinical trials tested the safety and efficacy of Nivolumab, including a Phase I open-label trial of 296 patients, 107 of which with advanced, unresectable melanoma. 30.8% of the 296 patients showed an objective response, with an estimated duration of 2 years for the response. The median overall survival time for patients was 16.8 months. 84.1% of the 107 patients with melanoma experienced an adverse reaction, but 22.4% were serious effects. The cost of a single dose for a 70 kg patient is estimated to be $7000, and it is administered via IV every 2 weeks.
It is encouraging to see new targets and treatment alternatives for different types of cancers, although the cost is very high. With more oral and IV medications emerging as valid treatment options, do you think this can have a significant impact on treatment for the disease? Do you think it is likely that more patients would opt for a treatment option like this over chemotherapy?