Open AccessIpilimumab for Patients With Advanced Mucosal Melanoma
Author(s) -
Postow Michael A.,
Luke Jason J.,
Bluth Mark J.,
Ramaiya Nikhil,
Panageas Katherine S.,
Lawrence Donald P.,
Ibrahim Nageatte,
Flaherty Keith T.,
Sullivan Ryan J.,
Ott Patrick A.,
Callahan Margaret K.,
Harding James J.,
D'Angelo Sandra P.,
Dickson Mark A.,
Schwartz Gary K.,
Chapman Paul B.,
Gnjatic Sacha,
Wolchok Jedd D.,
Hodi F. Stephen,
Carvajal Richard D.
Publication year - 2013
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2012-0464
Subject(s) - medicine , ipilimumab , common terminology criteria for adverse events , immune system , adverse effect , rash , melanoma , response evaluation criteria in solid tumors , immunology , progressive disease , cancer , oncology , disease , immunotherapy , cancer research
The outcome of patients with mucosal melanoma treated with ipilimumab is not defined. To assess the efficacy and safety of ipilimumab in this melanoma subset, we performed a multicenter, retrospective analysis of 33 patients with unresectable or metastatic mucosal melanoma treated with ipilimumab. The clinical characteristics, treatments, toxicities, radiographic assessment of disease burden by central radiology review at each site, and mutational profiles of the patients' tumors were recorded. Available peripheral blood samples were used to assess humoral immunity against a panel of cancer‐testis antigens and other antigens. By the immune‐related response criteria of the 30 patients who underwent radiographic assessment after ipilimumab at approximately week 12, there were 1 immune‐related complete response, 1 immune‐related partial response, 6 immune‐related stable disease, and 22 immune‐related progressive disease. By the modified World Health Organization criteria, there were 1 immune‐related complete response, 1 immune‐related partial response, 5 immune‐related stable disease, and 23 immune‐related progressive disease. Immune‐related adverse events (as graded by Common Terminology Criteria for Adverse Events version 4.0) consisted of six patients with rash (four grade 1, two grade 2), three patients with diarrhea (one grade 1, two grade 3), one patient with grade 1 thyroiditis, one patient with grade 3 hepatitis, and 1 patient with grade 2 hypophysitis. The median overall survival from the time of the first dose of ipilimumab was 6.4 months (range: 1.8–26.7 months). Several patients demonstrated serologic responses to cancer‐testis antigens and other antigens. Durable responses to ipilimumab were observed, but the overall response rate was low. Additional investigation is necessary to clarify the role of ipilimumab in patients with mucosal melanoma.