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Nivolumab in the treatment of advanced melanoma

Introduction: In recent years, a number of novel drugs, such as BRAF inhibitors, MEK inhibitor and anti-cytotoxic T lymphocyte 4 antibody, have been shown to render significant clinical benefit, including improvement in overall survival in patients with advanced melanoma. However, a majority of patients will not be cured with these drugs. Most recently, monoclonal anti-PD-1 antibodies such as nivolumab and pembrolizumab have shown very promising results in patients with advanced melanoma. Areas covered: This article discusses the mechanisms of action, rationale, clinical efficacy, and safety of nivolumab for the treatment of patients with advanced melanoma. Clinical trial data of a nivolumab-containing checkpoint inhibitor combination are also discussed. Expert opinion: Nivolumab, a checkpoint inhibitor, represents a novel class of drugs which are capable of stimulating cytotoxic T lymphocytes, resulting in a high and durable response rate. The currently available clinical data suggest that nivolumab, as well as other anti-PD1 antibodies, is very likely to improve long-term survival of patients with advanced melanoma. Furthermore, nivolumab-based combination therapy will likely be a new standard for systemic therapy in patients with metastatic melanoma in the near future.