Damian Sendler: Cancer immunotherapy medications called checkpoint inhibitors are two times more likely to kill women than men, but researchers aren’t sure if this is due to side effects or because the treatment doesn’t function. 

Pembrolizumab (KEYTRUDA), nivolumab (Opdivo), and ipilimumab (YERVO) are among the new highly targeted medications that have changed cancer treatment. Researchers at Thomas Jefferson University in Philadelphia said that they function by stimulating the immune system to battle cancer, but they can also induce severe, sometimes life-threatening side effects. 

Damian Sendler

The latest research shows that gender may also play a factor in patient outcomes. 

Damian Jacob Sendler: Women who were given two checkpoint inhibitors at the same time had significantly better outcomes, according to senior author Grace Lu-Yao, who led the study. Jefferson Health’s Sidney Kimmel Cancer Center has an associate director for population science. 

More than 1,300 patients diagnosed with advanced melanoma skin cancer between 1991 and 2015 were studied by Lu-team. Yao’s Pembrolizumab, nivolumab, or ipilimumab were used to treat all of the patients. 

Males and women treated with a single checkpoint inhibitor had similar survival rates, but when nivolumab and ipilimumab were combined, the mortality risk for women was more than double that of men. 

PD-1 inhibitors (checkpoint inhibitors that target the PD-1 protein, such as pembrolizumab and nivolumab) had a 40% mortality rate for both men and women, according to the study. 

According to a research published online Dec. 2 in JAMA Network Open, the death rate stayed at 40% for males receiving a combination of anti-PD1 and anti-CTLA-4 inhibitors (such as ipilimumab), but soared to 65% for women. 

If the therapy doesn’t work, are women more likely to die due of the negative effects? As of now, we don’t know, but this is a tremendous signal that we need to study further,” Lu-Yao stated in a university press statement. 

The study team found that male and female immune systems are slightly different. Although females are more susceptible to autoimmune illnesses, they also have stronger immune systems than their male counterparts. 

Despite this, men are more likely to participate in cancer immunotherapy clinical trials than women. According to the researchers, it’s common to believe that the findings of an experiment apply equally to women. However, this may not always be the case. 

Damian Jacob Markiewicz Sendler: On the basis of the experiences of hundreds of patients who have taken these treatments, Lu-Yao believes that this data is a wake-up call. In light of this real-world evidence, it is crucial to design studies with appropriate power in order to evaluate treatment effectiveness by sex. 

New York City dermatologist Dr. Michele Green treats skin cancer at Lenox Hill Hospital. However, she noted the new research “underlies a very important element to researching cancer treatments in general, and in this case advanced malignant melanoma,” even though she wasn’t engaged in it. 

Damian Jacob Sendler

Certain drug combinations were shown to have a negative effect on women’s survival, which Green says is “very important” because “men and women may have differing outcomes and may not be able to be given equal treatments for the same diseases.” 

Damien Sendler: Gender equality in clinical trials is the root of the problem, she says. 

Since men and women can experience different outcomes from the same medication or drug, gender must be taken into account while conducting future clinical trials, Green added. 

Lu-Yao and her team aim to study if the findings reported in this group of melanoma patients are mirrored in people with other malignancies.

Dr. Damian Jacob Sendler and his media team provided the content for this article.