Rosie Qin1, Adam Olson2, Bhavana Singh3, Samantha Thomas4, Steven Wolf4, Nrupen A Bhavsar3, Brent A Hanks5, Joseph K Salama2, April K S Salama6. 1. School of Medicine, Duke University Medical Center, Durham, North Carolina. 2. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina. 3. Department of Medicine, Duke University Medical Center, Durham, North Carolina. 4. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina. 5. Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina. 6. Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina. Electronic address: april.salama@duke.edu.
Abstract
PURPOSE: Ipilimumab and radiation therapy (RT) are standard treatments for advanced melanoma; preclinical models suggest the potential for synergy. However, limited clinical information exists regarding safety and optimal timing of the combination. METHODS AND MATERIALS: We reviewed the records of consecutive patients with unresectable stage 3 or 4 melanoma treated with ipilimumab. Patients were categorized as having received RT or not. Differences were estimated between these 2 cohorts. RESULTS: We identified 88 patients treated with ipilimumab. At baseline, the ipilimumab-plus-RT group (n=44) had more unfavorable characteristics. Despite this, overall survival, progression-free survival, and both immune-related and non-immune-related toxicity were not statistically different (P=.67). Patients who received ipilimumab before RT had an increased duration of irradiated tumor response compared with patients receiving ipilimumab after RT (74.7% vs 44.8% at 12 months; P=.01, log-rank test). In addition, patients receiving ablative RT had non-statistically significantly improved median overall survival (19.6 vs 10.2 months), as well as 6-month (95.1% vs 72.7%) and 12-month (79.7% vs 48.5%) survival rates, compared with those treated with conventionally fractionated RT. CONCLUSIONS: We found that both ablative and conventionally fractionated RT can be safely administered with ipilimumab without a clinically apparent increase in toxicity. Patients who received ipilimumab before RT had an increased duration of irradiated tumor response.
PURPOSE:Ipilimumab and radiation therapy (RT) are standard treatments for advanced melanoma; preclinical models suggest the potential for synergy. However, limited clinical information exists regarding safety and optimal timing of the combination. METHODS AND MATERIALS: We reviewed the records of consecutive patients with unresectable stage 3 or 4 melanoma treated with ipilimumab. Patients were categorized as having received RT or not. Differences were estimated between these 2 cohorts. RESULTS: We identified 88 patients treated with ipilimumab. At baseline, the ipilimumab-plus-RT group (n=44) had more unfavorable characteristics. Despite this, overall survival, progression-free survival, and both immune-related and non-immune-related toxicity were not statistically different (P=.67). Patients who received ipilimumab before RT had an increased duration of irradiated tumor response compared with patients receiving ipilimumab after RT (74.7% vs 44.8% at 12 months; P=.01, log-rank test). In addition, patients receiving ablative RT had non-statistically significantly improved median overall survival (19.6 vs 10.2 months), as well as 6-month (95.1% vs 72.7%) and 12-month (79.7% vs 48.5%) survival rates, compared with those treated with conventionally fractionated RT. CONCLUSIONS: We found that both ablative and conventionally fractionated RT can be safely administered with ipilimumab without a clinically apparent increase in toxicity. Patients who received ipilimumab before RT had an increased duration of irradiated tumor response.
Authors: V H Koelzer; K Glatz; L Bubendorf; A Weber; A Gaspert; G Cathomas; A Lugli; A Zippelius; W Kempf; K D Mertz Journal: Pathologe Date: 2017-05 Impact factor: 1.011
Authors: Osama Mohamad; Alberto Diaz de Leon; Samuel Schroeder; Andrew Leiker; Alana Christie; Elizabeth Zhang-Velten; Lakshya Trivedi; Saad Khan; Neil B Desai; Aaron Laine; Kevin Albuquerque; Puneeth Iyengar; Yull Arriaga; Kevin Courtney; David E Gerber; Hans Hammers; Hak Choy; Robert Timmerman; James Brugarolas; Raquibul Hannan Journal: Oncoimmunology Date: 2018-03-15 Impact factor: 8.110
Authors: Thomas Walle; Rafael Martinez Monge; Adelheid Cerwenka; Daniel Ajona; Ignacio Melero; Fernando Lecanda Journal: Ther Adv Med Oncol Date: 2018-01-18 Impact factor: 8.168
Authors: Matthew C Knox; Jie Ni; Andrej Bece; Joseph Bucci; Yaw Chin; Peter H Graham; Yong Li Journal: Front Immunol Date: 2020-07-22 Impact factor: 7.561