Ipilimumab After Progression on Anti-Pd-1 Treatment in Advanced Melanoma

ABSTRACT

Aim: While both efficacy and safety of anti-PD-1 agents seem to be independent of previous treatment with anti-CTLA-4, limited data exist of efficacy and toxicity of ipilimumab after progression on anti-PD-1 therapy. This retrospective analysis describes the efficacy and safety of sequential therapy with ipilimumab in patients with metastatic melanoma who progressed on anti-PD-1 antibody. Methods: Nine patients who progressed on anti-PD-1 therapy received four cycles of ipilimumab 3 mg/kg every 3 weeks. Results: Two out of nine patients (2/9; 22.2%) showed a partial response, and seven patients (7/9; 77.8%) experienced disease progression. Median progression-free survival was 3.14 months (95% CI: 2.56–3.71), and the median overall survival since the start of anti-PD-1 therapy was 16.8 months (95% CI: 8.1–25.4). Five (5/9; 55.6%) patients experienced grade 3 immune-related adverse events. No grade 4 or 5 adverse events were reported. Conclusion: In this small retrospective series of cases, the efficacy of ipilimumab post-anti-PD-1 was similar to that described in the previous reports on ipilimumab.

KEYWORDS:

• advanced melanoma
• anti-PD-1
• immune-related adverse event
• ipilimumab
• sequence of immunotherapies

Financial & competing interests disclosure

A Arance has received honoraria from Novartis, Roche, BMS and MSD for her participation in advisory boards and lectures. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. The authors thank Content Ed Net, Madrid, Spain, for providing editorial assistance in the preparation of this manuscript, with funding from Hospital Clinic Barcelona.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board (CEIC, Hospital Clinic-Barcelona) approval or have followed the principles outlined in the Declaration of Helsinki (Fortaleza 2013 update) for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.