Adjuvant Ipilimumab in High-Risk Uveal Melanoma

Uveal melanoma is a common intraocular malignant tumor that is uniformly fatal once metastatic. No effective adjuvant therapy currently exists to reduce the risk of distant metastasis after definitive treatment of the primary lesion. Immunotherapy has been used effectively in the adjuvant setting in...

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Bibliographic Details
Published in:Cancers 2019-01, Vol.11 (2), p.152
Main Authors: Fountain, Eric, Bassett, Roland L, Cain, Suzanne, Posada, Liberty, Gombos, Dan S, Hwu, Patrick, Bedikian, Agop, Patel, Sapna P
Format: Article
Language:English
Subjects:
Clinical trials
Consent
CTLA-4 protein
Dosage
Enrollments
Gene expression
Hepatitis
Immune checkpoint
Immunotherapy
Melanoma
Metastases
Metastasis
Patients
PD-1 protein
Radiation therapy
Toxicity
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Summary:Uveal melanoma is a common intraocular malignant tumor that is uniformly fatal once metastatic. No effective adjuvant therapy currently exists to reduce the risk of distant metastasis after definitive treatment of the primary lesion. Immunotherapy has been used effectively in the adjuvant setting in locally advanced cutaneous melanoma. We performed a Phase I/II clinical trial of adjuvant ipilimumab in high-risk primary uveal melanoma with distant metastasis-free survival (DMFS) as the primary objective. A total of 10 patients with genomically high-risk disease were treated: three at a dose of 3 mg/kg and seven at 10 mg/kg. Two of the seven patients at the higher dose had to discontinue therapy secondary to grade 3 toxicity. At 36 months follow-up, 80% of patients had no evidence of distant disease (95% CI, 58.7⁻100). With recent advancements in CTLA-4 inhibition, PD-1 inhibition, and combined checkpoint blockade, immunotherapy is a promising avenue of treatment in uveal melanoma. Further clinical trials are needed to elucidate the role of immunotherapy in the adjuvant setting.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers11020152