Relatlimab plus nivolumab versus nivolumab for advanced melanoma: 5-year survival and biomarker analyses of the phase 3 RELATIVITY-047 trial.

In metastatic or unresectable melanoma, nivolumab plus relatlimab shows continued 5-year benefit over nivolumab alone, with hazard ratios of 0.77 for PFS, 0.78 for OS, and 0.71 for MSS.

• Why it matters: Long-term outcomes and biomarker-linked efficacy patterns are needed to understand durability and resistance mechanisms beyond initial trial results in advanced melanoma.
• What they did: In the phase 2-3, double-blind RELATIVITY-047 trial (n=355 vs n=359; minimum follow-up 57.3 months), patients received nivolumab 480 mg plus relatlimab 160 mg or nivolumab 480 mg every 4 weeks, with prespecified 5-year OS, PFS, and MSS plus exploratory biomarker analyses.
• The result: Survival curves separated with clinically significant benefit for PFS, OS, and MSS, and in programmed death ligand 1 ≥1% biomarker-evaluable patients, worse outcomes with nivolumab were associated with high LAG-3+ CD8 cell levels; adding relatlimab was linked to lower primary resistance prevalence.