OBJECTIVES: PD-1 inhibitors are a novel group of checkpoint inhibitors that are being developed for the treatment of cancer. One such PD-1 inhibitor is nivolumab. The use of nivolumab for the adjuvant treatment of malignant melanoma in the was approved by the FDA in 2017. The adjuvant treatment of melanoma with nivolumab was found to reduce the risk of disease recurrence by 35% (Weber, 2017). This study assessed how the introduction of nivolumab for the adjuvant treatment of melanoma would affect the number of patients in developed countries progressing to more advanced disease, through the reduction of unresectable recurrence events over a ten-year forecast period.

METHODS: We obtained stage-specific melanoma incidence, resectability, cause-specific survival and recurrence-free survival estimates by performing systematic searches of current literature and country specific cancer registries. These estimates were used to build recurrence models to forecast the number drug-treatment opportunities in both the adjuvant and first line treatment setting for melanoma over 10-years (2018–2028). The effect of nivolumab on these drug treatment opportunities was modelled into this forecast as a function of recurrence risk reduction and estimated patient share, and differences in the two models were analysed.

RESULTS: By 2028, we forecast that the introduction of PD-1 inhibitors, like nivolumab, into the adjuvant treatment of melanoma will result in a 16.4% reduction in disease progression from unresectable recurrence events within developed countries. Nivolumab is also estimated to result in an 8.6% reduction of melanoma patients eligible for first line drug treatment.

CONCLUSIONS: This study provides quantitative evidence for the protective effect that PD-1 inhibitors, like nivolumab, have on patients eligible for adjuvant treatment of melanoma by reducing the risk of disease progression through recurrence. Innovations in treatments like PD-1 inhibitors within the adjuvant treatment settings across different cancers are likely to reduce the risk disease burden and increase survival.