Ipilimumab vs high dose interferon for high risk melanoma

This study wanted to find out which was the better treatment for advanced melanoma that has been surgically treated, ipilimumab (Yervoy) or high dose interferon alfa (HDI). The study found that low dose ipilimumab resulted in better overall survival than HDI and high dose ipilimumab, but all of the treatments had severe side effects. 

There are many ways to treat melanoma. Skin melanoma is commonly removed via surgery, but often additional treatment is needed to ensure there are no cancer cells left in the body. A common treatment for melanoma is called immunotherapy. Two different types of immunotherapy drugs are called ipilimumab and high-dose interferon alfa (HDI). However, it is not known which treatment works best for melanoma that has been surgically removed, HDI, ipilimumab at high doses, or ipilimumab at low doses.  

This study had 1670 patients. All of the patients had skin melanoma which was surgically removed. After, the patients were split into three groups. The first group had 636 patients, who were treated with HDI. 523 patients were treated with ipilimumab at 3mg/kg of weight (ipi3). The final group had 511 patients, who were treated with ipilimumab at 10mg/kg of weight (ipi10). The patients were followed up for an average of 57.4 months. 

Side effects occurred in patients in all three groups. 37% of patients who were treated with ipi3 had severe side effects. 79% of patients who were treated with HDI had severe side effects. 58% of patients who were treated with ipi10 had severe side effects. Side effects included skin rash, diarrhea, pancreatic and hormonal imbalances. 35% of patients who were treated with ipi3 stopped their treatment due to the side effects they were experiencing. 20% of patients who were treated with HDI stopped their treatment due to the side effects they were experiencing. 54% of patients who were treated with ipi10 stopped their treatment due to the side effects they were experiencing.

The patients who were treated with ipi3 had the best overall survival. After five years 72% of patients who were treated with ipi3 were alive. After five years 67% of patients who were treated with HDI were still alive. The survival for patients treated with ipi10 was not statistically different from those treated with HDI.

The study concluded that treatment with ipilimumab at 3mg/kg resulted in the best survival outcomes when compared with HDI and ipilimumab at 10mg/kg in patients with surgically removed melanoma.

This study received funding support from the Pharma Industry.