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Title
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Ipilimumab in melanoma
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Author
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Abstract
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| The treatment of melanoma has been evolving rapidly over the past few years. Patients with BRAFv600 mutations can be treated with a combination of a BRAF-inhibitor and an MEK-inhibitor. Check point inhibitors are treatment options both for patients with BRAF wild-type tumors and BRAFv600 mutated tumors. We conducted a comprehensive review of the literature on the efficacy, pre-dictive markers, safety, and pharmacoeconomics of ipili-mumab in melanoma. Ipilimumab was approved by the Food and Drug Administration and the European Medicines Agency for the treatment of metastatic melanoma in 2011. More recently, ipilimumab was also approved by FDA in the adjuvant setting for patients with high risk, stage III melanoma. The anti-PD1 directed antibodies pembrolizu-mab and nivolumab are superior to single agent ipilimumab, which can is no longer be considered the standard first line treatment in metastatic melanoma. The addition ipilimumab to nivolumab is associated with a higher response rate and a better progressen-free survival, particularly in patients with PD-L1 negative tumors, albeit at the cost of a steep increase in the incidence of grade 3-4 adverse events. Definitive survival data on this combination are pending. The optimal sequence (inhibition of BRAF and MEK followed by checkpoint inhibitor or the reverse) in patients with BRAFv600 mutated tumors is unknown. |
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Language
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Dutch
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Source (journal)
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Internal medicine review
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Publication
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2017
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DOI
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10.18103/IMR.V3I2.296
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Volume/pages
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3
:2
(2017)
, p. 1-32
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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