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01.07.2014 | Original Article | Ausgabe 7/2014

Cancer Immunology, Immunotherapy 7/2014

Immunological and biological changes during ipilimumab treatment and their potential correlation with clinical response and survival in patients with advanced melanoma

Zeitschrift:
Cancer Immunology, Immunotherapy > Ausgabe 7/2014
Autoren:
Ester Simeone, Giusy Gentilcore, Diana Giannarelli, Antonio M. Grimaldi, Corrado Caracò, Marcello Curvietto, Assunta Esposito, Miriam Paone, Marco Palla, Ernesta Cavalcanti, Fabio Sandomenico, Antonella Petrillo, Gerardo Botti, Franco Fulciniti, Giuseppe Palmieri, Paola Queirolo, Paolo Marchetti, Virginia Ferraresi, Gaetana Rinaldi, Maria Pia Pistillo, Gennaro Ciliberto, Nicola Mozzillo, Paolo A. Ascierto
Wichtige Hinweise
An erratum to this article can be found at http://​dx.​doi.​org/​10.​1007/​s00262-014-1611-2.

Abstract

Background

Ipilimumab can induce durable disease control and long-term survival in patients with metastatic melanoma. Identification of a biomarker that correlates with clinical benefit and potentially provides an early marker of response is an active area of research.

Patients and methods

Ipilimumab was available upon physician request for patients aged ≥16 years with stage III (unresectable) or IV cutaneous, ocular or mucosal melanoma, who had failed or did not tolerate previous treatments and had no other therapeutic option available. Patients received ipilimumab 3 mg/kg every 3 weeks for four doses. Tumour assessments were conducted at baseline, Week 12 and Week 24 using immune-related response criteria. Patients were monitored continuously for adverse events (AEs), including immune-related AEs. Candidate immunological markers were evaluated in peripheral blood and sera samples collected at baseline and Weeks 4, 7, 10 and 12.

Results

Among 95 patients treated with ipilimumab 3 mg/kg, the immune-related disease control rate at Week 24 was 38 %. With a median follow-up of 24 months, median overall survival was 9.6 months. Both disease control and survival were significantly associated with decreasing levels of lactate dehydrogenase, C-reactive protein and FoxP3/regulatory T cells, and increasing absolute lymphocyte count, between baseline and the end of dosing (Week 12).

Conclusion

Ipilimumab is a feasible treatment option for heavily pretreated patients with metastatic melanoma. Changes in some immunological markers between baseline and the fourth ipilimumab infusion appear to be associated with disease control and survival, but verification in prospective clinical trials is required.

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