Differences in the response to immunotherapy in men against women with advanced melanoma

In a population -based study, women with melanoma and previous treatment with iPilimumab that later received combined immunotherapy based on Nivolumab and Ipilimumab had an increase in more than the double in the risk of death, compared to their male counterparts.

The Hazard Ratio for Mortality in women against men treated with combined immunotherapy after previous treatment with iPilimumab was 2.6.In the investigation, such a difference was observed between those who received treatment with a single drug, outside Pmbrolizumab or Nivolumab (HR for mortality in women in front of men: 0.97; p = 0.85) or between patients who had notTreated before with iPilimumab.

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The women treated before with iPilimumab also almost tripled the risk of death after combined immunotherapy against anti-protein of programmed cell death-1 with a single drug, but none of these differences were observed in the men participating in the study.

The results indicate that the patient's sex should be taken into account when planning the treatment to optimize the results, the authors highlighted.

"These new findings point out that for women with a history of use of iPilimumab, treatment with programmed cell death anti-protein 1 can be preferable to combined treatment, while for men it is not clear which treatment is better," they said in the investigation.

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In a statement, the main author,Dr.a.GraceLu-Yao, in Philadelphia, United States, acknowledged that it has not yet been clarified whether the increased risk of death in women is due to the side effects of treatment or lack of efficacy, highlighting that: "This is a powerful signalIn real world data that is necessary to investigate more ".

"These data represent a care call based on the experience of hundreds of patients treated with these drugs.These real world data show that the results derived from men may not be applicable to women and it is essential to design studies with sufficient power to evaluate the efficacy of the treatment depending on sex, "said DRA.Lu-Yao.

The relevance of the findings for systematic practice is not clear, given the average age of cohort and the lack of data on whether the excess mortality was related to cancer or toxicity was due to another cause, said the DR.Jeffrey s.Weber, pH.D, Professor and Delegate Director of Laura And Isaac Perlmutter Cancer Center, of the New York University School of Medicine.

"The study is interesting and detailed, but it is a fairly limited cohort, whose members are over 65 years old and a median age of 75 years, which is very different from most cohorts of patients with melanoma treated withImmunotherapy with a median age 10 years younger, "said the DR.Weber in an interview.

In general, these data would not influence my way of treating patients.Dr..Jeffrey Weber

In addition "in the almost current practice it will have previously treated with iPilimumab and then receive combined immunotherapy.In general, these data would not have an impact on my way of treating patients, "he said.

This study is not the first that shows a sex difference in the results after immunotherapy.

A meta -analysis published in The Lancet Oncology showed that immune control points are twice as effective as standard cancer treatments in men with advanced solid tumors, compared to their female counterparts.

However, sex -based differences are still underestimated despite "evidence of the potential role that sex in the efficacy of drugs due to biological differences between men and women is accumulating," said the authors of the lastStudy on melanoma.

"This lack of attention around the association of sex with the efficacy of immunotherapy based on immune control points can have important negative consequences, especially because these drugs carry high toxicity and a high cost of treatment.For future essays, it would be crucial to examine the modification of the effect depending on sex, "they concluded.

Source consulted here.