Efficacy and toxicity of treatment with the anti-CTLA-4 antibody ipilimumab in patients with metastatic melanoma after prior anti-PD-1 therapy.
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ICR Authors
Authors
Bowyer, S
Prithviraj, P
Lorigan, P
Larkin, J
McArthur, G
Atkinson, V
Millward, M
Khou, M
Diem, S
Ramanujam, S
Kong, B
Liniker, E
Guminski, A
Parente, P
Andrews, MC
Parakh, S
Cebon, J
Long, GV
Carlino, MS
Klein, O
Prithviraj, P
Lorigan, P
Larkin, J
McArthur, G
Atkinson, V
Millward, M
Khou, M
Diem, S
Ramanujam, S
Kong, B
Liniker, E
Guminski, A
Parente, P
Andrews, MC
Parakh, S
Cebon, J
Long, GV
Carlino, MS
Klein, O
Document Type
Journal Article
Date
2016-05-10
Date Accepted
2016-03-14
Abstract
BACKGROUND: Recent phase III clinical trials have established the superiority of the anti-PD-1 antibodies pembrolizumab and nivolumab over the anti-CTLA-4 antibody ipilimumab in the first-line treatment of patients with advanced melanoma. Ipilimumab will be considered for second-line treatment after the failure of anti-PD-1 therapy. METHODS: We retrospectively identified a cohort of 40 patients with metastatic melanoma who received single-agent anti-PD-1 therapy with pembrolizumab or nivolumab and were treated on progression with ipilimumab at a dose of 3 mg kg(-1) for a maximum of four doses. RESULTS: Ten percent of patients achieved an objective response to ipilimumab, and an additional 8% experienced prolonged (>6 months) stable disease. Thirty-five percent of patients developed grade 3-5 immune-related toxicity associated with ipilimumab therapy. The most common high-grade immune-related toxicity was diarrhoea. Three patients (7%) developed grade 3-5 pneumonitis leading to death in one patient. CONCLUSIONS: Ipilimumab therapy can induce responses in patients who fail the anti-PD-1 therapy with response rates comparable to previous reports. There appears to be an increased frequency of high-grade immune-related adverse events including pneumonitis that warrants close surveillance.
Citation
British journal of cancer, 2016, 114 (10), pp. 1084 - 1089
Source Title
Publisher
SPRINGERNATURE
ISSN
0007-0920
eISSN
1532-1827
Collections
Research Team
Melanoma and Kidney Cancer