Hôpital Saint-Louis, Paris, France
Celeste Lebbé , Jeffrey S. Weber , Michele Maio , Bart Neyns , Kaan Harmankaya , Omid Hamid , Steven O'Day , Kevin M. Chin , Diane Opatt McDowell , Lori Cykowski , Brent McHenry , Jedd D. Wolchok
Background: Ipilimumab (Ipi) has shown improved overall survival (OS) in two phase III trials of patients (pts) with metastatic melanoma (MM), with survival follow-up of >4 years in one trial. The present analyses provide survival follow-up of >5 years in four phase II trials of Ipi in MM. Methods: Pts with MM were enrolled in one of four phase II trials: (1) CA184-004, a biomarker study with Ipi at 3 or 10 mg/kg in treatment-naive (TN) and previously treated (PT) pts; (2) CA184-007, with Ipi at 10 mg/kg +/- prophylactic budesonide in TN and PT pts; (3) CA184-008, a single-arm study with Ipi at 10 mg/kg in PT pts; and (4) CA184-022, a dose-ranging study of Ipi at 0.3, 3, or 10 mg/kg in PT pts (crossover from lower dose groups to 10 mg/kg was allowed upon disease progression). Ipi was administered q3 wk x4 (induction), followed by maintenance (q12 wk from week 24) in eligible pts. Some pts were retreated with Ipi at 10 mg/kg upon disease progression. Along with survival data collected through March 2012 for studies 007, 008, and 022, we report updated 5-year OS data for study 004 collected through September 2012. Results: Five-year OS rates for TN and PT pts are reported in studies 007, 008, and 022, with combined analyses for TN and PT pts within each dose group in study 004 (Table). The results show that survival rates reach a plateau beginning at year 3. Conclusions: In pts who received Ipi at 3 or 10 mg/kg in phase II studies, regardless of prior treatment, a proportion (12.3–49.5%) remained alive 5 years after the start of treatment. These results demonstrate long-term survival with Ipi therapy in MM. An ongoing phase III trial will compare OS for Ipi at 3 vs 10 mg/kg in pts with MM. Clinical trial information: NCT00162123.
Trial | N (prior Tx) | Ipi dose (mg/kg) |
Median OS, months |
OS rate, % | ||||
---|---|---|---|---|---|---|---|---|
1-yr | 2-yr | 3-yr | 4-yr | 5-yr | ||||
004 | 42 (14 TN, 28 PT) |
10 | 11.2 | 45.2 | 27.7 | 20.1 | 17.6 | 17.6 |
40 (14 TN, 26 PT) |
3 | 12.8 | 52.0 | 31.2 | 22.7 | 22.7 | 17.0 | |
008 | 155 (PT) | 10 | 10.2 | 47.2 | 32.8 | 23.3 | 19.7 | 18.2 |
022 | 72 (PT) | 10 | 11.4 | 48.6 | 29.8 | 24.8 | 21.5 | 21.5 |
72 (PT) | 3 | 8.7 | 39.3 | 24.2 | 19.7 | 18.2 | 16.5 | |
73 (PT) | 0.3 | 8.6 | 39.6 | 18.4 | 13.8 | 13.8 | 12.3 | |
007 | 57 (total) | 10 + placebo | 19.3 | 62.4 | 41.8 | 34.4 | 32.0 | 32.0 |
32 (TN) | 30.5 | 71.4 | 56.6 | 42.5 | 37.7 | 37.7 | ||
25 (PT) | 14.8 | 50.8 | 24.2 | 24.2 | 24.2 | 24.2 | ||
58 (total) | 10 + budesonide | 17.7 | 55.9 | 41.1 | 38.7 | 36.2 | 36.2 | |
21 (TN) | 45.0 | 65.9 | 57.7 | 57.7 | 49.5 | 49.5 | ||
37 (PT) | 8.5 | 49.9 | 31.6 | 28.4 | 28.4 | 28.4 |
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