Ipilimumab: report and comment about the MDX010-020 clinical trial. (December 2012)

• Record Type: Journal Article
• Authors: Luisa Nicoletti, Stefania Vittoria; de Rosa, Francesco; Ridolfi, Ruggero
• Is Part Of: Expert review of dermatology. Volume 7:Number 6(2012)
• Page Start: 507
• Page End: 512
• Publication Date: 2012-12
• Subjects: anti-CTLA-4 monoclonal antibody -- immunotherapy -- ipilimumab -- melanoma -- melanoma overall survival; Dermatology -- Periodicals; 616.5005
• DOI: 10.1586/edm.12.53
• Languages: English
• ISSNs: 1746-9872

Abstract

Ipilimumab is a human monoclonal antibody, that blocks cytotoxic T-lymphocyte antigen-4 (CTLA-4), normally expressed in activated T cells. CTLA-4 downregulates T-cell activation pathways and induces progressive immune tolerance. Blocking this downregulation, determines an enhancement of antitumor T-lymphocyte response. A recent randomized Phase III trial using ipilimumab (MDX020-010) demonstrated, for the first time, a statistically significant improvement in overall survival in patients with metastatic melanoma, prolonging median survival from 6.4 to 10.1 months. It is noteworthy that the study population was composed of previously treated patients, of whom more than 70% had poor prognostic factors and that the adverse events experienced were reversed with appropriate treatment. Further trials are now needed to evaluate the real impact of ipilimumab on survival and on response duration in treatment-naive patients. Clinical research is also warranted into the association of ipilimumab with chemoimmunotherapy and vaccines, and studies comparing different dosages and administration schedules could provide further useful information.