Ipilimumab — progress in therapy of advanced melanoma

Abstract

More than one thousand patients die due to cutaneous melanoma in Poland every year. Apart from high mortality constantly growing incidence with doubling rate in 10 years is also the great concern. Other problems include limited treatment modalities and unsatisfactory results of systemic therapy in advanced melanoma. Activation of antitumor immune response through blockade of CTLA-4 molecule expressed on T cells seems to be a promising treatment for melanoma. Randomized clinical trials showed that administration of anti-CTLA-4 antibodies statistically significantly prolongs overall survival of melanoma patients after failure of previous systemic therapy. Although clinical benefit is limited to minority of patients, this led to the market approval of this drug in US and Europe. Since kinetics of clinical response to ipilimumab is different from standard chemotherapy employment of the immune-related response criteria (modified RECIST criteria) is recommended for evaluation of objective responses to the therapy. The risk of immune related adverse events necessitates careful patient selection and incisive observation during and after ipilimumab treatment. Prompt application of appropriate immunosuppressive and supportive therapy might enable to avoid uncontrolled activation of autoreactive immune response.
Onkol. Prak. Klin. 2011; 7, 5: 231–245