Ipilimumab activity in advanced uveal melanoma

Abstract

Uveal melanoma (UM) is a rare disease with a distinct molecular profile. About half of the patients with UM eventually develop metastatic disease. The prognosis of these patients remains poor. Treatment options are limited and none of them have been able to show a survival benefit. Ipilimumab was the first agent to show a survival benefit in patients with cutaneous melanoma in a randomized trial; however, there is limited published evidence for its role in the management of advanced UM. Here, we report our experience of ipilimumab in five patients with advanced UM treated at an academic cancer centre in the UK. Two patients had durable stable disease and three developed progressive disease. Of the patients with stable disease, one maintained disease control at 11 months from the commencement of treatment with ∼10% reduction in tumour volume compared with the baseline, and the second patient progressed after 15 months. We also examined the tumour kinetics and response patterns that resembled that of ipilimumab in cutaneous melanoma. Given the lack of randomized trial data, our findings indicate that ipilimumab might be a reasonable treatment option for patients with advanced UM.

Current and Future Roles of Targeted Therapy and Immunotherapy in Advanced Melanoma

“…Evidence of the efficacy and safety of ipilimumab in patients with these rare melanoma subtypes is limited; however, preliminary data from expanded access programs (EAPs) or single-institution studies provide some indication of activity. [47][48][49][50][51] Cumulatively, data have been reported from 228 patients with metastatic ocular melanoma treated with ipilimumab at 3 mg/kg. Median OS ranged from 6 to 10.3 months, with one-third of patients surviving at least 1 year from starting treatment.…”

Management of Uveal Melanoma: A Consensus-Based Provincial Clinical Practice Guideline

“…Furthermore, most systemic therapies for metastatic uveal melanoma (largely modelled after therapies for cutaneous melanoma) have failed to demonstrate clinical efficacy in phase ii trials [65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] . However, immunotherapies, including the anti-ctla4 antibody ipilimumab, have shown some success in retrospective and expanded-access studies [82][83][84][85][86][87] . Pooling those publications, 188 patients with advanced uveal melanoma treated with ipilimumab experienced 1 complete response, 7 partial responses, and 52 incidences of stable disease.…”

Ipilimumab Activity in Advanced Uveal Melanoma: A Pooled Analysis

“…Nine articles were included in this study; including Phase II clinical trials (n = 2), Expanded Access Programs (EAP) (n = 4) and retrospective studies (n = 3) [14][15][16][17][18][19][20][21][22]. The key features of each trial are summarized in Table 1.…”