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Sequencing Ipilimumab Immunotherapy Before or After Chemotherapy (Nab-Paclitaxel and Bevacizumab) for the Treatment of BRAFwt (BRAF Wild-Type) Metastatic Malignant Melanoma
- Source :
- American Journal of Clinical Oncology. 43:115-121
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Objectives With the introduction of novel immune therapeutics for the treatment of disseminated malignancies, we sought to evaluate whether deliberate sequencing of immunotherapy before/after conventional cytotoxic chemotherapy would have an impact on clinical outcomes in patients with previously treated metastatic melanoma. We sought to evaluate whether or not ipilimumab immunotherapy administered before or after cytotoxic chemotherapy (nab-paclitaxel+bevacizumab, AB) would impact clinical outcomes. Methods We conducted a randomized phase 2 clinical trial of patients with BRAF wild-type metastatic melanoma (up to 2 prior therapies) who received either: (A) AB followed by ipilimumab therapy at progression; or (B) ipilimumab followed by AB treatment at progression. The primary goal of the study was a comparison of AB versus ipilimumab progression-free survival, with secondary clinical and laboratory endpoints. Results This study did not reach full accrual due to concurrent Food and Drug Administration approval of anti-programmed cell death 1 agents. Nevertheless, the available data suggests a cumulative therapeutic advantage to the sequential use of ipilimumab followed by AB. Correlative laboratory data revealed a favorable effect on systemic immune homeostasis in patients receiving AB therapy, of potential interest in further investigations, especially in the context of chemotherapy/immunotherapy combinations. Conclusion Albeit limited in scope, our data suggest that cytotoxic therapy with nab-paclitaxel and bevacizumab appear to favorably alter systemic parameters of immune function of potential benefit in combination T-cell directed immune checkpoint inhibitor therapy.
- Subjects :
- Adult
Male
Proto-Oncogene Proteins B-raf
Cancer Research
Lung Neoplasms
Skin Neoplasms
Time Factors
Paclitaxel
Bevacizumab
medicine.medical_treatment
Phases of clinical research
Bone Neoplasms
Ipilimumab
Drug Administration Schedule
03 medical and health sciences
Antineoplastic Agents, Immunological
0302 clinical medicine
Albumins
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
030212 general & internal medicine
Progression-free survival
Melanoma
Aged
Aged, 80 and over
Chemotherapy
business.industry
Eye Neoplasms
Liver Neoplasms
Immunotherapy
Middle Aged
medicine.disease
Progression-Free Survival
Clinical trial
Oncology
030220 oncology & carcinogenesis
Cancer research
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 02773732
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- American Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....4fb8800389d4e78bffcbb46bb40e90d6