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Research in Review

Ipilimumab Combination Significantly Improves Melanoma Outcomes

Ipilimumab (Yervoy; Bristol-Myers Squibb) combined with local peripheral treatments such as radiotherapy or electrochemotherapy may significantly prolong survival in patients with melanoma compared with ipilimumab alone, according to a retrospective clinical study published in Cancer Immunology Research.

Ipilimumab is part of a new line of immunotherapy treatments that target cancer mechanisms rather than the tumor itself, harnessing the body’s immune system to attack cancerous cells. Since its release, ipilimumab has helped to profoundly change the landscape of melanoma care; however, scientists continue to look for new ways to improve patient response and expand the benefits of the drug to a wider patient population.
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Therefore, investigators led by Sebastian Theurich, MD, Center of Integrated Oncology at the University Hospital of Cologne, Germany, conducted a retrospective study analyzing how outcomes changed for patients with melanoma when they were treated with ipilimumab alone or ipilimumab plus local peripheral treatments to relieve tumor-related symptoms.

A total of 127 patients were included in the analysis, 82 of which received ipilimumab alone and 45 whom received ipilimumab in addition to local peripheral treatment. Dr Theurich and his colleagues found that the median overall survival was much higher in those who received the combination regimen compared with those who were treated with ipilimumab alone (93 weeks vs 42 weeks, respectively).

Further analysis also showed that when patients with brain metastases were removed from the analysis due to an unequal distribution between the two study groups, the median overall survival benefit for the group receiving ipilimumab and peripheral treatment grew to 117 weeks compared with only 46 weeks for those who only received ipilimumab.

“We found that adding local peripheral treatments, including external radiotherapy, electrochemotherapy, or internal radiotherapy, to systemic ipilimumab treatment doubled survival chances in our patient cohort and did not increase immune-related side effects,” Dr Theurich concluded. “Importantly, this survival advantage seemed to overcome even traditional risk factors of poor outcomes. This suggests that this combination could be an option for all patients with malignant melanoma, and this is being tested in ongoing prospective clinical trials.”

However, they did also note that the study was limited by its retrospective nature, meaning that data were not collected prospectively or in a randomized fashion. The validity of the results is now being tested in prospective clinical trials.