Melanoma Patients Treated With Rx Combination Lived Longer

Ipilimumab plus sargramostim may improve survival in patients with advanced melanoma more than ipilimumab alone

(RxWiki News) Once melanoma skin cancer spreads to other parts of the body, patients' survival rates drop. But treatment with a combination of medications may increase survival in these patients.

A new study compared the safety and effectiveness of ipilimumab (brand name Yervoy) and ipilimumab plus sargramostim (brand name Leukine) for treatment of advanced melanoma.

Patients who took the combination of medications lived longer and had fewer side effects. The combination did not increase the amount of time before the disease advanced, though.

The study was conducted by F. Stephen Hodi, MD, of the Dana-Farber Cancer Institute in Boston, and colleagues.

Melanoma is a type of skin cancer that starts in cells that produce melanin, which gives skin its color. Melanoma is the most dangerous type of skin cancer. When a patient has advanced melanoma, the cancer has spread to other parts of the body.

In the study, 245 patients with advanced melanoma were treated with either ipilimumab or ipilimumab plus sargramostim. The study authors noted how long the patients lived, how long until their disease got worse and what side effects they had.

Ipilimumab is an antibody that attaches to normal cells in the immune system. This makes the immune system better able to destroy cancer cells. Sargramostim is a medication that boosts the immune system by helping the bone marrow make more white blood cells that can help fight melanoma tumors.

One year after receiving treatment, 69 percent of the patients who took the combination treatment were alive — compared to 53 percent of those who took only ipilimumab.

The overall survival of patients who took ipilimumab only was about 13 months — compared to 17.5 months for those who took the combination of medications.

The disease spread more in the body about three months following treatment in both groups, the authors noted.

The most common serious side effects were stomach and intestinal problems. These occurred in about 27 percent of the patients who took the single medication — compared to 16 percent who took both. More patients who took ipilimumab only (58 percent) had serious side effects from the treatment than patients who took both medications (45 percent).

"These findings require confirmation in larger sample sizes and with longer follow-up," the authors wrote.

The research was published online Nov. 4 in JAMA.

Several sources funded the research, such as grants from the Public Health Service and the National Cancer Institute. Several authors made financial disclosures. David F. McDermott, MD, John M. Kirkwood, MD, and Ahmad Tarhini, MD, PhD, received personal fees from Bristol-Myers Squibb, which makes ipilimumab. Dr. Hodi received personal fees from Sanofi, the company than makes sargramostim.


Review Date: 
November 4, 2014