Home Forums Melanoma Diagnosis: Stage IV nivolumab vs pembrolizumab

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  • #22154
    hass71
    Participant

    hello

    is there a difference between these two medication or is it just a competition between two companies?

    #65332
    Catherine Poole
    Keymaster

    It sure is nice for melanoma patients to finally have choices! The ASCO meeting and concensus among most of the melanoma experts there was that Pembro (Merck) had the edge on BMS NIVO. I believe it is in the 10% range, but it is also still very early in the game for certainty.

    #65333
    Jonathan
    Participant

    As suggested, this is still an unsettled issue, and probably won’t be for the forseeable future, since the 2 companies simply aren’t going to run a head-to-head trial. They clearly are both excellent drugs, and again as suggested, the Merck trials of Pembro suggest a slightly greater response rate. However, my oncologist, for one, points out that the trial population samples were rather different, with the Nivo patients in that trial considerably sicker to begin with, so their poorer response could be because of that….I’m on Pembro and getting a fine response, so I don’t have a prob recommending it if you can get it…

    Jonathan

    #65334
    rick1981
    Participant

    Yes, “the jury is still out” but it seems to be pretty close in terms of efficacy. What is a plus for pembro is that apparently the side effects tend to be less strong.

    #65335
    Catherine Poole
    Keymaster

    I think there is more data on Pembro, since they had many trials running, hence the approval looming near. Haven’t heard of any difference in side effects or similarity. There are some issues that haven’t been resolved like why some data showed previous IPI lowered the response to Pembro but not by a lot, again, I think as Jonathan points out, much depends on tumor burden.

    #65336
    rick1981
    Participant

    Hi Catherine,

    Not sure if you can compare this one-on-one (because of different types of trials potentially and the impact of ipi), but this is what I found on the side effects:

    Pembro

    From Asco 2014: http://www.ascopost.com/ViewNews.aspx?nid=16291

    “…with a toxicity profile that is almost unheard of in metastatic cancer—10% or 12%. This is really extraordinary about this class of drugs”

    Nivolumimab (combined with Ipi):

    From Asco 2014: http://www.ascopost.com/ViewNews.aspx?nid=16293

    “combining ipilimumab with nivolumab did result in increased toxicity compared to therapy with either single agent. Grade 3/4 side effects occurred in 58 of the 94 patients (62%)”

    #65337
    Catherine Poole
    Keymaster

    The two companies will be very unlikely to pit their Pd1s against each other. So, looks like we won’t know until some time passes.

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