INTRODUCTION Anti-PD-1 antibodies are commonly used as frontline therapy for patients with metastatic melanoma. Although these medications can cause long term responses, a significant number of patients will not respond or will lose response. Optimal second-line therapy after losing response to anti-PD-1 antibodies is not well established. Therefore, we retrospectively compared the overall survival of patients who lost response to anti-PD1 antibodies between patients treated with single agent ipilimumab or ipilimumab and nivolumab. METHODS A de-identified U.S. nationwide electronic health record-derived database was reviewed for patients with advanced melanoma treated with single agent anti-PD1 antibodies in the frontline setting and who subsequently received second-line ipilimumab or combination ipilimumab and nivolumab. Overall survival from initiation of second-line therapy was compared using Kaplan Meier curves and log-rank analysis. Other known prognostic markers for melanoma were analyzed for correlation with survival in a similar fashion. Disease characteristics between the two groups were compared using chi-square analysis. RESULTS A total of 842 patients with advanced melanoma who received frontline anti-PD-1 antibodies were included for analysis. Of these, 57 received either ipilimumab (n = 22) or ipilimumab in combination with nivolumab (n = 35) in the second-line setting. Median survival from second-line therapy initiation for those treated with ipilimumab alone was 6 months and was 5.6 months for those treated with combination ipilimumab and anti-PD-1 antibodies, p = 0.81. CONCLUSIONS In this small, retrospective analysis, for patients who lost response to frontline anti-PD-1 therapy, patients treated with ipilimumab had similar survival to those who received ipilimumab in combination with anti-PD-1 antibodies.

中文翻译：

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在接受一线抗PD-1抗体的晚期黑色素瘤患者中，二线ipilimumab与nivolumab联合ipolimumab的比较疗效。

简介抗PD-1抗体通常用作转移性黑色素瘤患者的一线治疗。尽管这些药物可引起长期反应，但仍有大量患者无反应或失去反应。对抗PD-1抗体失去反应后的最佳二线治疗尚不完善。因此，我们回顾性比较了在单药ipilimumab或ipilimumab和nivolumab治疗的患者之间对抗PD1抗体失去反应的患者的总生存期。方法对前线环境中使用单药抗PD1抗体治疗并随后接受二线ipilimumab或ipilimumab和nivolumab联合治疗的晚期黑色素瘤患者，回顾了一个不确定的美国全国电子健康记录数据库。使用Kaplan Meier曲线和对数秩分析比较了开始二线治疗后的总生存期。以类似的方式分析了其他已知的黑色素瘤预后标志物与生存的相关性。使用卡方分析比较两组之间的疾病特征。结果共纳入842例接受一线抗PD-1抗体治疗的晚期黑色素瘤患者。其中，在二线治疗中，有57例接受了ipilimumab（n = 22）或ipilimumab与nivolumab（n = 35）的联合治疗。单独使用ipilimumab治疗的患者从二线治疗开始的中位生存期为6个月，而使用ipilimumab和抗PD-1抗体联合治疗的患者中位生存期为5.6个月，p = 0.81。结论在这个小的回顾性分析中，