Dr. Atkins on Long-Term Outcomes of the CheckMate-204 Trial in Melanoma

Michael B. Atkins, MD, deputy director, Georgetown-Lombardi Comprehensive Cancer Center, discusses long-term outcomes of the phase II CheckMate-204 trial in metastatic melanoma.

In the expanded portion of the trial, patients with asymptomatic brain metastases as well as those with symptomatic brain metastases who were on low doses of steroids or had just come off of steroid treatment received the combination of nivolumab (Opdivo) and ipilimumab (Yervoy).

At a median follow-up of 20.6 months, the objective response rate (ORR) with the combination was 54% among patients with asymptomatic brain metastases. However, the data were not as compelling in the symptomatic cohort, says Atkins. Specifically, of the 18 patients with symptomatic brain metastases, there were 4 responses, 2 complete responses, and 2 partial responses, reflecting a 22% ORR. Moreover, the majority of these patients had difficulty receiving more than 1 dose of therapy due to swelling in the brain or increased dosages of steroids. Given the suboptimal responses, additional strategies should be explored for patients with symptomatic brain metastases, concludes Atkins.