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Int J Radiat Oncol Biol Phys. 2016 Sep 1;96(1):72-7. doi: 10.1016/j.ijrobp.2016.04.017. Epub 2016 Apr 21.

Safety and Efficacy of Radiation Therapy in Advanced Melanoma Patients Treated With Ipilimumab.

Author information

1
School of Medicine, Duke University Medical Center, Durham, North Carolina.
2
Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
3
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
4
Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
5
Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina.
6
Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina. Electronic address: april.salama@duke.edu.

Abstract

PURPOSE:

Ipilimumab and radiation therapy (RT) are standard treatments for advanced melanoma; preclinical models suggest the potential for synergy. However, limited clinical information exists regarding safety and optimal timing of the combination.

METHODS AND MATERIALS:

We reviewed the records of consecutive patients with unresectable stage 3 or 4 melanoma treated with ipilimumab. Patients were categorized as having received RT or not. Differences were estimated between these 2 cohorts.

RESULTS:

We identified 88 patients treated with ipilimumab. At baseline, the ipilimumab-plus-RT group (n=44) had more unfavorable characteristics. Despite this, overall survival, progression-free survival, and both immune-related and non-immune-related toxicity were not statistically different (P=.67). Patients who received ipilimumab before RT had an increased duration of irradiated tumor response compared with patients receiving ipilimumab after RT (74.7% vs 44.8% at 12 months; P=.01, log-rank test). In addition, patients receiving ablative RT had non-statistically significantly improved median overall survival (19.6 vs 10.2 months), as well as 6-month (95.1% vs 72.7%) and 12-month (79.7% vs 48.5%) survival rates, compared with those treated with conventionally fractionated RT.

CONCLUSIONS:

We found that both ablative and conventionally fractionated RT can be safely administered with ipilimumab without a clinically apparent increase in toxicity. Patients who received ipilimumab before RT had an increased duration of irradiated tumor response.

PMID:
27375168
DOI:
10.1016/j.ijrobp.2016.04.017
[Indexed for MEDLINE]

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