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2016 ; 5
(8
): e1201625
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Ipilimumab administered to metastatic melanoma patients who progressed after
dendritic cell vaccination
#MMPMID27622070
Boudewijns S
; Koornstra RH
; Westdorp H
; Schreibelt G
; van den Eertwegh AJ
; Geukes Foppen MH
; Haanen JB
; de Vries IJ
; Figdor CG
; Bol KF
; Gerritsen WR
Oncoimmunology
2016[Aug]; 5
(8
): e1201625
PMID27622070
show ga
BACKGROUND: Ipilimumab has proven to be effective in metastatic melanoma
patients. The purpose of this study was to determine the efficacy of ipilimumab
in advanced melanoma patients who showed progressive disease upon experimental
dendritic cell (DC) vaccination. METHODS: Retrospective analysis of 48 stage IV
melanoma patients treated with ipilimumab after progression upon DC vaccination
earlier in their treatment. DC vaccination was given either as adjuvant treatment
for stage III disease (n = 18) or for stage IV disease (n = 30). Ipilimumab
(3 mg/kg) was administered every 3 weeks for up to 4 cycles. RESULTS: Median time
between progression upon DC vaccination and first gift of ipilimumab was 5.4 mo.
Progression-free survival (PFS) rates for patients that received ipilimumab after
adjuvant DC vaccination, and patients that received DC vaccination for stage IV
melanoma, were 35% and 7% at 1 y and 35% and 3% at 2 y, while the median PFS was
2.9 mo and 3.1 mo, respectively. Median overall survival of patients pre-treated
with adjuvant DC vaccination for stage III melanoma was not reached versus 8.0 mo
(95% CI, 5.2-10.9) in the group pre-treated with DC vaccination for stage IV
disease (HR of death, 0.36; p = 0.017). Grade 3 immune-related adverse events
occurred in 19% of patients and one death (2%) was related to ipilimumab.
CONCLUSIONS: Clinical responses to ipilimumab were found in a considerable number
of advanced melanoma patients with progression after adjuvant DC vaccination for
stage III disease, while the effect was very limited in patients who showed
progression after DC vaccination for stage IV disease.