Comparative effectiveness of pembrolizumab and nivolumab as first-line treatment for advanced/unresectable or metastatic melanoma: A propensity-score adjusted analysis from a US national health system.
Randomized trial compared safety and effectiveness of pembrolizumab versus nivolumab in advanced melanoma, suggesting interchangeability.
Key Points
This research aims to compare the effectiveness and safety of pembrolizumab and nivolumab as treatments for advanced melanoma.
Data from the Veterans Affairs health system for pembrolizumab and nivolumab from 2015 to 2025 were analyzed.
Patients with BRAF mutations or those treated with ipilimumab/nivolumab were excluded.
Cox models and Kaplan-Meier estimates were used for outcome analysis.
Median time-to-next treatment was 14.6 months for pembrolizumab and 13.2 months for nivolumab (aHR 0.93, 95% CI 0.78, 1.11; p=0.43).
Median overall survival was 27.9 months for pembrolizumab and 25.3 months for nivolumab (aHR 0.97, 95% CI 0.80, 1.17; p=0.73).
Two-year cumulative event rates of prolonged corticosteroid use were 22.1% for pembrolizumab and 23.5% for nivolumab (aHR 1.02, 95% CI 0.71, 1.47; p=0.93).