Surgery after ipilimumab is safe for patients with metastatic melanoma

In this study, researchers examined the safety of surgery for patients with metastatic melanoma who recently received treatment with ipilimumab (Yervoy).

Ipilimumab is a drug that uses the patients’ own immune systems to fight cancer cells. It is FDA-approved for the treatment of patients with metastatic melanoma, which is cancer of the pigmented cells of the body (melanocytes) that has spread to other areas of the body. When a metastasis occurs, surgery is necessary to remove the new tumor. However, it is not clear whether patients who have recently received ipilimumab have more risks of complications from surgery.

Researchers evaluated 23 patients with metastatic melanoma who had received ipilimumab and underwent any surgery within 30 days from the last dose of ipilimumab, Complications after surgery were low, and most of the patients had mild complications. Patients with progressive disease (cancer that still grows and spreads after treatment) despite ipilimumab therapy who had surgery for symptomatic disease had a shorter survival after surgery (5.3 months) than patients who did not have any symptoms (9.5 months). In addition, approximately 1 year after starting ipilimumab therapy, 13% of patients had no signs of melanoma.

In summary, surgery after recent ipilimumab treatment is generally safe for metastatic melanoma patients. Although usually surgery if recommended at least 4 weeks after the last dose of ipilimumab, this study showed that the risk of complications is small, therefore surgery should not be delayed. 

This study included a very small number of patients. Larger studies are needed in order to confirm these findings.

Several authors have previously been affiliated with Bristol Myers Squibb, the manufacturer of ipilimumab.