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Ipilimumab in Pretreated Patients With Advanced Malignant Melanoma: Results of the South African Expanded-Access
Bernardo L Rapoport1, Daniel A Vorobiof1, Lydia M Dreosti1
1, Medical Oncology Centre of Rosebank; , Sandton Oncology Center; , Wits Oncology Donald Gordon Medical Center; , Bristol-Myers Squibb South Africa, Johannesburg; , University of Pretoria, Pretoria; , Rondebosch Oncology Medical Center, Cape Town; , Westridge Oncology Center, Durban; and , , and , HEXOR, Midrand, South Africa.
Purpose:
The primary objective of this study was to evaluate 1- and 2-year survival rates and durable remissions in pretreated patients with advanced (unresectable or metastatic) malignant melanoma treated with ipilimumab in a South African expanded-access program (SA-EAP).
Patients And Methods:
This multicenter, retrospective study obtained data from pretreated patients with advanced malignant melanoma who were eligible for the ipilimumab SA-EAP. Ipilimumab was administered at a dose of 3 mg/kg intravenously every 3 weeks for four cycles to adults with advanced melanoma for whom at least one line of treatment for metastatic disease had failed. Data from the medical records of 108 patients treated within the SA-EAP were collected and statistically analyzed to determine overall (OS) and progression-free survival (PFS) at 1 and 2 years.
Results:
In the population of 108 patients, a median OS of 8.98 months (95% CI, 7.47 to 10.79 months) was observed. One-year OS was 36% (95% CI, 26% to 45%), and 2-year survival was observed as 20% (95% CI, 12% to 27%). The median survival without progression (ie, PFS) was 3.44 months (95% CI, 2.98 to 4.16 months), and 1- and 2-year PFS were 22% (95% CI, 14% to 29%) and 14% (95% CI, 8% to 21%), respectively. The longest recorded survival was 3.4 years. No independent prognostic variables were identified to predict for OS by multivariate Cox proportional hazards model.
Conclusion:
In this multicenter South African setting, ipilimumab at a dose of 3 mg/kg was an effective treatment with long-term OS in a subset of patients with pretreated advanced malignant melanoma.