Efficacy and safety of nivolumab alone or in combination
with ipilimumab in patients with mucosal melanoma: a pooled analysis.
He was instrumental in the clinical development leading to the approval
of ipilimumab for advanced melanoma, and recently designed and led a global phase 3 trial of combined checkpoint blockade for melanoma.
A study of six people with these variations, out of 79 patients who were previously treated with
ipilimumab for metastatic melanoma, found a higher likelihood of progression - free survival.
Overall, significant (grade 3 - 4) side effects related to treatment occurred in 55 %, 16 % and 27 % of patients in the combination, nivolumab and
ipilimumab groups respectively.
«Combined checkpoint inhibitor treatments, such
as ipilimumab - nivolumab, have produced higher response rates, but they can have serious side effects.
To date, several thousand cancer patients have
received ipilimumab treatment in clinical trials for a variety of cancers, either as a monotherapy or in combination with other drugs.
Moffitt Cancer Center researchers participated in an international phase 3 study that demonstrated that a drug
called ipilimumab improves the relapse - free survival of advanced stage melanoma patients rendered free of disease surgically but at high risk for relapse.
The study, which included researchers from 19 countries, compared
ipilimumab treatment in 475 people to placebo treatment in 476 people.
This open label, multicentre, phase 1B trial investigated the safety and efficacy of omaveloxolone in combination with the checkpoint
inhibitors ipilimumab or nivolumab.
For those aged 75 and over (118 patients), the average progression - free survival time for those on the combination treatment could not be calculated as the patients» disease had not progressed yet; it was 5.3 months for those on nivolumab alone and four months for those
on ipilimumab alone.
In conclusion, Dr. Schadendorf said that «even though the nivolumab plus
ipilimumab arm had a higher frequency of adverse events, no clinically meaningful health - related QoL changes from baseline were observed in any of the treatment arms.
We
gave ipilimumab at 1 mg / kg and nivolumab at 3 mg / kg, and that regimen was much better tolerated.
Results of an EORTC trial appearing in The Lancet Oncology show that
adjuvant Ipilimumab significantly improves recurrence - free survival in patients with completely resected stage III melanoma at high risk of disease recurrence, but that this treatment was also associated with a high rate of immune - related adverse events.
They determined that
ipilimumab improved survival in mice that had a genetic mutation that caused a partial loss of Aire.
In 2011, the FDA
approved ipilimumab for melanoma, and the pharma giant Bristol Myers - Squibb — which had acquired Medarex — began marketing it as Yervoy.
Early data from a small phase Ib / II study [23] of
ipilimumab combined with T - VEC, which demonstrated that the combination offers much higher complete and overall response rates than have been seen with either agent alone, appear to confirm that there are beneficial synergies between these two therapeutic modalities.
A recent study, she said, looked at adjuvant nivolumab
vs ipilimumab in patients with resected stage III or IV melanoma.
They are investigating other bacteria that could influence other immune therapies, such at the CTLA - 4 pathway, exploited
by ipilimumab.
The drug
Ipilimumab works similarly to the CTLA - 4 mutation, meaning that immune system T - cells are no longer properly inhibited and can more efficiently attack the malignant skin cancer cells.
Mathias Chamaillard at the University of Lille, France, and his colleagues discovered that the skin cancer
drug ipilimumab isn't as effective at treating cancer in mice born without bacteria in their gut, compared with mice with normal bacteria.
As reported in 2015, the study met its primary endpoint after a median follow up of 2.3 years, with
ipilimumab significantly improving recurrence - free survival.2 The drug was subsequently approved by the US Food and Drug Administration as adjuvant therapy for stage III melanoma.
I know a patient who was treated at UCLA in the phase I trial almost 12 years ago, who said that when she was first told
about ipilimumab she had failed every other drug and was hoping to hang on long enough to see her two sons graduate from high school.
I twice said that if Pien ever
got ipilimumab approved by the FDA I would write him a note of apology.
Additional studies are required to ensure that the benefit of this dose of
ipilimumab does not outweigh the added toxicity risks.
Checkpoint inhibitors
like ipilimumab — which has been on the market since 2011 — nivolumab, and pembrolizumab stop tumor cells from stimulating the receptors.
Patients in the clinical trial who got the combined therapies also had fewer serious adverse side effects than those who received
only ipilimumab, the researchers report in the Journal of the American Medical Association.
Ipilimumab targets the CTLA - 4 checkpoint on T cells and was the first immune checkpoint inhibitor.
And of those 20 patients, more than half couldn't finish the 12 - week induction regimen because we used the high dose of
ipilimumab at 3 mg / kg, whereas nivolumab was given at 1 mg / kg.
Some of the most dramatic clinical responses seen in recent years have occurred with checkpoint blockade antibodies,
including ipilimumab (anti-CTLA-4) and nivolumab (anti-PD-1).
A recent study showed that T - VEC in combination with
ipilimumab resulted in an overall response rate of 50 %, durable response rate of 44 %, and tolerable safety profile in patients with advanced melanoma, said Georgina Long, BSc, PhD, MBBS, of the Melanoma Institute Australia in Sydney.
Since ipilimumab arrived on the scene, a number of other molecules have caught researchers» attention.
He had reason to think so, because clinical benefits had been seen in cancer patients who received
ipilimumab along with cancer vaccines that pumped out GM - CSF.
Dr. Fong is experienced in research and clinical studies with the dendritic cell immunotherapy vaccine sipuleucel - T (Provenge) as well as the anti-CTLA-4 checkpoint
immunotherapy ipilimumab.
Ipilimumab counters the CTLA - 4 signal, allowing T - cells to launch a full - scale attack on cancer cells.
The EORTC 18071 phase III trial
evaluated ipilimumab as adjuvant therapy for patients with high risk stage III melanoma.
Our intention with this study was to
assess Ipilimumab as an adjuvant treatment for patients with completely resected stage III melanoma at high risk of recurrence.
In fact,
ipilimumab proved to be the first medication to significantly expand median survival rates in patients with advanced melanoma — from six months to 11.
After declaring Belvin in remission, the oncologist introduced her to the man
behind ipilimumab, immunologist James P. Allison.
The drug's mechanism of action was entirely new: Instead of attacking cancer cells (like chemo), or indiscriminately revving up the immune system (like IL - 2),
ipilimumab blocked a single receptor on one type of immune cell.
By blocking CTLA - 4,
ipilimumab releases the brake, allowing cell - killing T cells to assault the cancer cells.
In addition, combining the anti-RANKL antibody with
ipilimumab produced a synergistic effect and helped prolong survival.
About 20 % of melanoma patients treated with
ipilimumab live longer, for example.
Ipilimumab interferes with a process by which the immune system controls the activation of T cells that destroy diseased tissues.
Ipilimumab often triggers colitis, an inflammation of the large intestine, where part of our microbiome lives.
Furthermore, 5 patients on
ipilimumab died during treatment due to adverse events.