How safe and effective is retreatment with ipilimumab in advanced melanoma?

The authors analyzed the effectiveness and safety of retreatment with ipilimumab (Yervoy) in patients with advanced melanoma. 

The survival rate in advanced melanoma is poor. Ipilimumab, an immunotherapy (treatment that uses the body’s own immune system to fight cancer), is an approved drug for the treatment of advanced melanoma (stage III/IV – cancer that has spread from the primary site into lymph nodes [sites that hold the immune cells] and around the body). Treatment with ipilimumab has shown long-term survival benefits in advanced melanoma that cannot be surgically removed. However, once the treatment is stopped, tumors may start to grow again in patients whose tumors were not completely eliminated.

In order to prevent tumor regrowth, immune systems in such patients need to be reactivated. One of the ways to reactivate the immune system is to start ipilimumab treatment again once the disease has progressed. This is known as retreatment.

The authors aimed to evaluate the effectiveness and safety of retreatment with ipilimumab in advanced melanoma.

855 patients were initially treated with ipilimumab. This was known as induction therapy (first phase of treatment used to treat cancer). Of these, 51 patients were retreated with ipilimumab upon disease progression. 55% of these patients achieved control of disease progression after retreatment. 42% of patients retreated with ipilimumab were alive after 2 years following first induction therapy. The average overall survival (patients who were still alive following treatment) from the beginning of the induction therapy was 21 months for those who received retreatment with ipilimumab. This was compared to 13 months in patients who did not receive retreatment.

22% of patients experienced mild to moderate treatment-related adverse events. These were mainly itching of the skin, diarrhea and fatigue.

The authors concluded that retreatment with ipilimumab was well tolerated and effective in controlling progression of disease in advanced melanoma.