Immunotherapy has changed the way doctors treat advanced skin cancer, especially malignant melanoma, which is the most dangerous type of skin cancer.
These powerful drugs help the immune system find and destroy cancer cells. But they also come with a price—strong side effects that can be hard to handle for many patients.
Now, a new study from Karolinska Institutet in Sweden brings some hopeful news. It shows that a lower dose of a common immunotherapy treatment not only reduces side effects but also leads to better outcomes for patients.
The treatment in question combines two drugs, nivolumab and ipilimumab. This combo has been widely used for people with advanced melanoma. However, ipilimumab, which is the more expensive and toxic part of the combination, often causes serious side effects.
In Sweden, doctors have more freedom to adjust drug doses compared to other countries, where fixed dosages are often required by law or insurance rules. This allowed researchers to study what happens when patients are given a lower dose of ipilimumab.
The study looked at nearly 400 patients with advanced melanoma that could not be removed by surgery. Some patients received the standard, higher dose of ipilimumab, while others were treated with the lower dose that many Swedish doctors had started using.
The results were surprising and promising. Patients who received the lower dose had a better response to treatment—49% of them responded well, compared to 37% in the standard-dose group.
More importantly, patients on the lower dose lived longer and stayed healthier for a longer time. Their median progression-free survival—the length of time they lived without the disease getting worse—was nine months, compared to only three months for those on the higher dose. Their overall survival was also much better: 42 months versus just 14 months.
Side effects were also reduced. Only 31% of the patients in the low-dose group experienced serious side effects, compared to 51% in the standard-dose group. This means that fewer patients had to stop treatment due to health problems, giving the therapy more time to work against the cancer.
The researchers believe that the improved results may be partly due to patients being able to stay on treatment longer, thanks to the lower rate of side effects. It also suggests that the immune system may respond better with a more gentle push, rather than being overwhelmed by high doses of medication.
However, this study was a retrospective observational study. This means that the researchers looked back at patient records rather than setting up a randomized controlled trial.
So, while the results are very encouraging, we can’t say for certain that the lower dose is the direct reason for the better outcomes. Still, even after adjusting for age, cancer stage, and other health differences between patients, the positive effects of the lower dose remained strong.
In conclusion, this study gives hope to patients and doctors treating melanoma. It shows that sometimes, less really can be more—lower doses may be safer, more effective, and help patients live longer. It also opens the door to future research that could change how cancer treatments are given, not just in Sweden, but around the world.
If you care about skin health, please read studies about eating fish linked to higher risk of skin cancer, and Vitamin B3 could help prevent skin cancers.
For more health information, please see recent studies about vegetable oil linked to spread of cancer, and results showing Vitamin D could help treat skin inflammation.
The study is published in JNCI Journal of the National Cancer Institute.
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