ISSUE 1367
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The FDA has approved ipilimumab (Yervoy – Bristol-Myers Squibb), a recombinant human monoclonal antibody, for treatment of unresectable or metastatic melanoma.
MECHANISM OF ACTION — Ipilimumab blocks cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), a negative regulator of the immune system, thus potentiating a T-cell mediated antitumor immune response.
STANDARD TREATMENT — Treatment options for unresectable or metastatic melanoma are limited. Dacarbazine (DTIC) is generally used, but has not shown a survival benefit. High-dose interleukin-2 (aldesleukin; Proleukin) therapy has produced responses in 16% of patients and a complete response in 6%; five years later, none of the responding patients had experienced disease progression. Severe toxicity has, however, limited its use.1 Addition of a gp100 peptide vaccine to high-dose
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