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Early, late initiation of ipilimumab induce similar response rates in unresectable or metastatic melanoma
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NEW YORK — The timing of ipilimumab initiation in the course of treatment for unresectable or metastatic melanoma had no significant effect on treatment response, according to results of a retrospective review presented at HemOnc Today Melanoma and Cutaneous Malignancies.
Ipilimumab (Yervoy, Bristol Meyers Squibb) — an anti–CTLA-4 antibody — effectively treats unresectable or metastatic melanoma.
The agent is used to treat patients who present with unresectable or metastatic disease at the time of their initial diagnosis, as well as for those with prior early-stage melanoma who develop a recurrence of unresectable or metastatic melanoma.
Joyce Au, MD, of Fox Chase Cancer Center, and colleagues reviewed data from 57 patients with unresectable or metastatic melanoma who initiated treatment with ipilimumab between 2011 and 2014 to determine whether the timing of initiation affected treatment outcomes.
Overall response rate (ORR) and survival served as the primary endpoints.
Fifteen patients (26.3%) received ipilimumab near the time of initial diagnosis or within 6 months of initial surgery, and 42 patients (73.7%) received ipilimumab more than 6 months after initial surgery. In the latter group, 14 patients underwent prior systemic therapy, such as with cytokines, tumor-infiltrating lymphocytes therapy, chemotherapy, imatinib (Gleevec, Novartis) or BRAF inhibitors.
The analysis included 53 evaluable patients. Researchers reported a 13.2% ORR, including three (5.7%) complete responses and four (7.5%) partial responses. Another five patients (9.4%) had stable disease, and 41 (77.4%) had progressive disease.
Researchers reported no statistically significant difference in response rate between treatment groups. Three of 14 (21.4%) patients in the early treatment group and four of 29 patients (13.7%) in the late treatment group achieved a response.
After median follow-up of 10 months, six of the seven patients (85%) who responded to ipilimumab remained alive, compared with only 11 of the 46 patients (23.9%) who did not respond to treatment (P = .001).
“There is no difference in the response to ipilimumab whether it is initiated early or late in the course of the melanoma disease,” Au and colleagues wrote. “[However], those who respond to ipilimumab have a striking improvement in survival.” – by Kristie L. Kahl
Disclosure: Au reports no relevant financial disclosures.
Reference: Au JT, et al. Response to ipilimumab treatment when initiated at different time points of the disease course in melanoma. Presented at: HemOnc Today Melanoma and Cutaneous Malignancies; March 18-19, 2016; New York.