We review the literature on managing the adverse effects and kinetics of tumor regression with ipilimumab and provide guidelines on their management
2012
Key concepts
Scholarcy highlights
- Monoclonal antibodies directed against the immune checkpoint protein cytotoxic T-lymphocyte antigen-4—ipilimumab and tremelimumab—have been investigated in metastatic melanoma and other cancers and have shown promising results
- We review the literature on managing the adverse effects and kinetics of tumor regression with ipilimumab and provide guidelines on their management
- Recognition of immune-related adverse events and initiation of treatment are critical to reduce the risk of sequelae
- IrAEs correlated with treatment response in some studies
- Unique kinetics of response have been observed with CTLA-4 blockade with at least four patterns: response in baseline lesions by week 12, with no new lesions seen; stable disease, followed by a slow, steady decline in total tumor burden; regression of tumor after initial increase in total tumor burden; and reduction in total tumor burden during or after the appearance of new lesion(s) after week 12
- We provide a detailed description of irAEs and recommendations for practicing oncologists who are managing them, along with the unusual kinetics of response associated with ipilimumab therapy
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