Combining ipilimumab with local treatments for melanoma may improve survival

Abstract

Patients with malignant melanoma who received both ipilimumab (Yervoy) and local peripheral treatments such as radiotherapy and electrochemotherapy had significantly prolonged overall survival in comparison with patients who received only ipilimumab, according to a study conducted by researchers from University Hospital in Cologne, Germany.1 Their work, published in Cancer Immunology Research, involved the analysis of data from 127 patients with malignant melanoma who were treated consecutively at 4 cancer centers in Germany and Switzerland. Eighty-two patients in the group received ipilimumab only, whereas 45 received ipilimumab plus local peripheral treatment to relieve tumor-related symptoms. Findings showed that the median overall survival was 93 weeks for patients in the combined group and 42 weeks for the ipilimumab-only group. The median overall survival benefit for patients receiving ipilimumab in addition to local peripheral treatment remained after the exclusion of patients with brain metastases from the analysis (these patients were excluded because they were not equally distributed between the groups). For patients without brain metastases, the median overall survival was 117 weeks in the combined group and 46 weeks in the ipilimumab-only group. Lead author Sebastian Theurich, MD, notes that the survival advantage seemed to overcome traditional risk factors for poor outcomes, and this suggests that the combination could benefit all patients with malignant melanoma. The data echo the results of a previous study of 29 patients in the United States who were treated with ipilimumab and local radiotherapy, says Dr. Theurich, and this further validates his team's results. The researchers have also begun investigating whether adding local peripheral treatments activates patients' immune cells; they are exploring this question further in prospective studies.