Use of ipilimumab resulted in better rates of recurrence-free, overall, and distant metastasis–free survival compared with placebo in people with stage III melanoma in a randomized trial involving 951 individuals. Those who took the drug had more immune-related adverse events.
Patients had previously undergone complete resection, and were randomly assigned to receive ipilimumab 10 mg/kg (n=475) or placebo (n=476) every 3 weeks for 4 doses. They continued therapy every 3 months for up to 3 years. Among the results:
- The 5-year rate of recurrence-free survival was 41% in the ipilimumab group, vs 30% in the placebo cohort.
- Overall survival rates were 65% and 54%, respectively.
- Distant metastasis–free survival rates were 48% and 39%, respectively.
- Grade 3 or 4 adverse event rates were 54% and 26%, respectively.
- Grade 3 or 4 immune-related adverse event rates were 41% and 3%, respectively; 5 patients in the ipilimumab group died due to immune-related adverse events.
Eggermont A, Chiarion-Sileni V, Grob J, et al. Prolonged survival in stage III melanoma with ipilimumab adjuvant therapy. [Published online ahead of print October 8, 2016]. N Engl J Med. doi:10.1056/NEJMoa1611299.
This Week's Must Reads
Perioperative radiation therapy underused in elderly patients with soft tissue sarcomas, Venigalla S et al. Intl J Rad Oncology*Biology*Physics; September (102) 2018: 155-165. https://doi.org/10.1016/j.ijrobp.2018.05.019
Age, R0 resection, and adjuvant radiotherapy boost outcomes in myxofibrosarcoma, Boughzala-Bennadji R et al. Intl J Rad Oncology*Biology*Physics; October (102) 2018: 399-406. https://doi.org/10.1016/j.ijrobp.2018.05.055
Tumor size, invasion beyond subcutaneous fat predict adverse outcomes in undifferentiated pleomorphic sarcoma, Winchester D et al. J Am Acad Dermatol. Available online 19 May 2018 https://doi.org/10.1016/j.jaad.2018.05.022
High recurrence rate after pancreaticoduodenectomy for primary retroperitoneal sarcoma, Tseng W et al. European Journal of Surgical Oncology 2018 (44): June; 810-815.
Nivolumab, pembrolizumab successfully used in Kaposi sarcoma, Galanina et al. Cancer Immunol Res. 2018 Sept 7. doi: 10.1158/2326-6066.CIR-18-0121.
Must Reads in Melanoma
Nivolumab plus ipilimumab ups survival in melanoma patients with brain mets, Tawbi HA et al. N Engl J Med. 2018 Aug 23. doi: 10.1056/NEJMoa1805453
Pregnancy does not increase melanoma recurrence risk, DiSano JA et al. J Surg Res. 2018 Jun 16. doi: 10.1016/j.jss.2018.05.026.
FDA Approves First Treatment for Rare Skin Cancer, FDA news release; 2017 Mar 23
High-Dose Interferon vs Observation for Melanoma , J Clin Oncol; ePub 2017 Jan 30; Agarwala, et al
Trends in US Melanoma Incidence and Mortality, JAMA Dermatol; ePub 2016 Dec 21; Glazer, et al