In a nutshell
The authors analyzed the effectiveness of ipilimumab (Yervoy) combined with fotemustine (Muphoran) in advanced melanoma patients.
Some background
In advanced melanoma (stage III/IV), cancer spreads rapidly from the skin to other parts of the body. This is known as metastasis. Immunotherapy is an effective treatment option used in advanced melanoma. It uses the body’s own immune system to attack the tumor cells and kill them. Ipilimumab is an approved immunotherapy for melanoma. It works by inhibiting important proteins in the immune system. One of the most serious and common complications of metastatic melanoma is spreading of the cancer to the brain. In separate studies, ipilimumab and fotemustine – a chemotherapy – have shown effectiveness in treating advanced melanoma with brain metastasis.
It would be beneficial to understand the utility of combination therapy with ipilimumab and fotemustine in advanced melanoma.
Methods & findings
The aim of this study was to evaluate the outcome of advanced melanoma in patients with or without brain metastasis treated with ipilimumab plus fotemustine.
86 advanced melanoma patients were included in this study. 20 patients had brain metastasis. 7 of these 20 patients were previously treated with radiotherapy (directing a beam of radiation to the tumor site to kill cancer cells). All patients received ipilimumab every 3 weeks and fotemustine every week. The median (mid-point) follow up time was 39.9 months.
The median overall survival (patients still alive following the treatment) for all patients was 12.9 months. It was 12.7 months for patients with brain metastasis. The 3-year survival rate was 28.5% for all patients. It was 27.8% for patients with brain metastases. Patients with lower neutrophil to lymphocyte ratios at the early stage of treatment had better survival. Neutrophil and lymphocytes are different types of white blood cells (cells of the immune system). Immune-related side-effects occurred in 21% of patients. This included itching of the skin and a rapid increase in the production of immune cells.
The bottom line
The authors concluded that combination therapy with ipilimumab and fotemustine was effective in treating advanced melanoma patients.
The fine print
A larger patient population is needed for the results to be widely applied.
Published By :
Annals of oncology
Date :
Dec 23, 2014
