New combination treatment improves overall survival in patients with malignant melanoma -
Bottom Line: Among patients with melanoma, those who received both ipilimumab (Yervoy) and treatment local devices such as radiation therapy or ECT had a significantly prolonged overall survival compared to those who received only ipilimumab, according to a retrospective clinical study
Journal in which the study was published :. Cancer Immunology Research , a journal of the American Association for Cancer Research
Author :. Theurich Sebastian, MD, professor and medical researcher at Integrated Oncology Centre (IOC) at the University Hospital of Cologne, Germany
Background :. ipilimumab is an immunotherapy that has revolutionized the treatment of malignant melanoma, a very aggressive type of skin cancer, according Theurich. About 20 percent of patients receiving ipilimumab achieve lasting responses, which is a major advance compared with historical results, but doctors-scientists are looking for ways to increase the percentage of patients that take a long-term benefit of this immunotherapy, he added.
Currently, local treatment devices are not used to try to cure patients with malignant melanoma; rather, they are used to relieve the symptoms caused by melanoma tumors, explained Theurich
How the study was conducted and the results :. Theurich and colleagues analyzed data from 127 patients with malignant melanoma who were treated consecutively at four cancer centers in Germany and Switzerland. Eighty-two patients received ipilimumab alone and 45 received ipilimumab and the local device treatment to relieve symptoms associated with the tumor.
The median overall survival for patients receiving ipilimumab and the local device treatment was 93 weeks against 42 weeks for those receiving. only ipilimumab
After excluding patients with brain metastases from the analysis because these patients are not evenly distributed between the two treatment groups, the median overall survival benefit for those receiving ipilimumab and local peripheral treatment remained - 117 weeks compared to 46 weeks for those receiving ipilimumab only
Author Comment :. "We found that adding local devices treatments, including external beam radiation therapy, ECT, or internal radiation therapy, systemic therapy ipilimumab doubled the chances of survival in our cohort of patients and did not increased side effects related to immunity, "said Theurich. "Importantly, this survival advantage seemed overcome even traditional risk factors for poor outcomes. This suggests that this combination could be an option for all patients with malignant melanoma, which is currently being tested in prospective clinical trials underway.
"Our results are consistent with those previously reported for 29 patients in the US with ipilimumab and local radiotherapy," continued Theurich. "Having data from different parts of the world enhances the validity of the results, especially if you are dealing with retrospective analyzes. In addition, all patients were treated with the same dose of ipilimumab, while those of the previous study received doses ranging because they have been treated in a clinical trial with dose escalation.
"We have also been able to begin studying the potential immunological mechanism underlying the benefit of adding a local device ipilimumab treatment," added Theurich. "It seems that the local treatment devices activate immune cells, which are then able to attack tumors at sites outside the local treatment site, however, we study this new in prospective studies.".
limitations: According Theurich, the main limitations of the study are that data are collected prospectively and randomly, but the validity of the results is being tested in prospective clinical trials.
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