Ipilimumab plus dacarbazine increases survival time in advanced melanoma patients

In this study researchers examined whether ipilimumab is effective in the treatment of advanced melanoma. Treatment with ipilimumab plus dacarbazine was compared to treatment with dacarbazine plus a placebo, and the effect on survival and quality of life was reviewed.

For many years, dacarbazine (DTIC) was the only approved medication for the treatment of advanced melanomas (one that has spread beyond the skin to other organs). However, dacarbazine treatment has not proven to prolong survival, and has serious adverse effects. Recently, the new drug ipilimumab (yervoy) has been approved for the treatment of melanomas. Ipilimumab works by inhibiting the signal which allows cancer cells to evade destruction by the immune system.

This study included 502 patients with inoperable melanomas (melanomas that cannot be entirely removed with surgery). 250 patients received ipilimumab plus dacarbazine and 252 patients received dacarbazine plus a placebo. After treatment, the researchers monitored melanoma progression, cancer related symptoms, and adverse events. These were combined to adjust survival for the patient's quality of life. Quality adjusted survival was significantly improved in patients receiving ipilimumab. This increased benefit was seen one year after treatment, and grew steadily in the following years.

Treatment of advanced melanomas with ipilimumab plus dacarbazine prolongs survival and provides a better quality of life than dacarbazine treatment alone.

Although authors reported the benefits of ipilimumab 2 to 4 years after treatment, the sample size reviewed in the last years after treatment was relatively small. Future studies should assess the long-term survival benefits of ipilimumab.

Consult with your physician about ipilimumab for the treatment of advanced melanomas.