Evidence map›Paper›PMID 38783238›Full record

ArticleBMC cancer2024

Safe Stop IPI-NIVO trial: early discontinuation of nivolumab upon achieving a complete or partial response in patients with irresectable stage III or metastatic melanoma treated with first-line ipilimumab-nivolumab - study protocol.

J C Janssen, B van Dijk, K de Joode, M J B Aarts, F W P J van den Berkmortel, C U Blank, M J Boers-Sonderen, A J M van den Eertwegh, J W B de Groot, M Jalving and 12 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05652673 (Safe Stop IPI-NIVO Trial), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05652673 narecruitingnot on this map

Safe Stop IPI-NIVO Trial: Early Discontinuation of Nivolumab Upon Achieving a (confirmed) Complete or Partial Response in Patients with Irresectable Stage III or Metastatic Melanoma Treated with First-line Ipilimumab-nivolumab

TypeinterventionalSponsorErasmus Medical CenterRan2023 to 2029Enrolled80ConditionsMelanoma Stage IV, Melanoma Stage III, Immunotherapy, Toxicity, DrugArmsnivolumab
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Survival after cessation of immunotherapies in melanoma: A systematic review and meta-analysis.Journal of the European Academy of Dermatology and Venereology : JEADV · 2025
    Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

J C Janssen *Department of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
B van Dijk *Department of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
K de JoodeDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
M J B AartsDepartment of Medical Oncology, Maastricht UMC+, Maastricht, The Netherlands.
F W P J van den BerkmortelDepartment of Medical Oncology, Zuyderland MC, Sittard-Geleen, The Netherlands.
C U BlankDepartment of Medical Oncology, NKI-AvL, Amsterdam, The Netherlands.
M J Boers-SonderenDepartment of Medical Oncology, Radboudumc, Nijmegen, The Netherlands.
A J M van den EertweghDepartment of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
J W B de GrootDepartment of Medical Oncology, Isala Zwolle, Zwolle, The Netherlands.
M JalvingDepartment of Medical Oncology, UMC Groningen, Groningen, The Netherlands.
M J A de JongeDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
A JoosseDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
E KapiteijnDepartment of Medical Oncology, Leiden UMC, Leiden, The Netherlands.
A M Kamphuis-HuismansDepartment of Medical Oncology, UMC Utrecht, Utrecht, The Netherlands.
K A T NaipalDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
D PiersmaDepartment of Medical Oncology, Medisch Spectrum Twente, Enschede, The Netherlands.
B RikhofDepartment of Medical Oncology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
H M WestgeestDepartment of Medical Oncology, Amphia Ziekenhuis, Breda, The Netherlands.
G VreugdenhilDepartment of Medical Oncology, Maxima Medisch Centrum Veldhoven, Veldhoven, The Netherlands.
E Oomen-de HoopDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
E E A P MulderDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands.
Astrid A M van der VeldtDepartment of Medical Oncology and Radiology and Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015GD, The Netherlands. a.vanderveldt@erasmusmc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with irresectable stage III or metastatic melanoma presenting with poor prognostic factors are usually treated with a combination of immune checkpoint inhibitors (ICIs), consisting of ipilimumab and nivolumab. This combination therapy is associated with severe immune related adverse events (irAEs) in about 60% of patients. In current clinical practice, patients are usually treated with ICIs for up to two years or until disease progression or the occurrence of unacceptable AEs. The incidence of irAEs gradually increases with duration of treatment. While durable tumour responses have been observed after early discontinuation of treatment, no consensus has been reached on optimal treatment duration. The objective of the Safe Stop IPI-NIVO trial is to evaluate whether early discontinuation of ICIs is safe in patients with irresectable stage III or metastatic melanoma who are treated with combination therapy.

methodsThe Safe Stop IPI-NIVO trial is a nationwide, multicentre, prospective, single-arm, interventional study in the Netherlands. A total of 80 patients with irresectable stage III or metastatic melanoma who are treated with combination therapy of ipilimumab-nivolumab and have a complete or partial response (CR/PR) according to RECIST v1.1 will be included to early discontinue maintenance therapy with anti-PD-1. The primary endpoint is the rate of ongoing response at 12 months after start of ICI. Secondary endpoints include ongoing response at 24 months, disease control at different time points, melanoma specific and overall survival, the incidence of irAEs and health-related quality of life. DISCUSSION: From a medical, healthcare and economic perspective, overtreatment should be prevented and shorter treatment duration of ICIs is preferred. If early discontinuation of ICIs is safe for patients who are treated with the combination of ipilimumab-nivolumab, the treatment duration of nivolumab could be shortened in patients with a favourable tumour response.

trial registrationClinicalTrials.gov ID NCT05652673, registration date: 08-12-2022.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsIpilimumabMelanomaNivolumabFemaleHumansImmune Checkpoint InhibitorsMaleMulticenter Studies as TopicNeoplasm StagingNetherlandsProspective StudiesSkin NeoplasmsWithholding TreatmentImmune Checkpoint InhibitorsIpilimumabNivolumabDiscontinuation of treatmentImmune checkpoint inhibitorsIpilimumabMelanomaNivolumabTreatment duration

Identifiers

PMID38783238
PMCPMC11112744

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.