Assessing Ipilimumab Targeting CTLA-4 for Metastatic Melanoma Treatment: Surgical Perspectives

Abstract

Abstract
Ipilimumab treatment demonstrates significant tumor responses in patients battling metastatic melanoma. Our study examines 179 assessable patients across three clinical trials, with long-term follow-up aimed at gauging response sustainability. Patients, enrolled between 2015 and 2022, underwent treatment across three protocols: Protocol 1 involved ipilimumab combined with gp100 peptides for fifty-six patients, Protocol 2 utilized ipilimumab with interleukin-2 for thirty-six patients, and Protocol 3 administered ipilimumab with intra-patient dose escalation and randomized gp100 peptide administration for eighty-five patients. Analysis of their extended follow-up and survival metrics reveals compelling insights. Median follow-up durations for Protocols 1, 2, and 3 were 92, 84, and 71 months, respectively. Median survival rates stood at 14, 16, and 13 months, with corresponding five-year survival rates of 13%, 25%, and 23%. Protocol 2 demonstrated a notable 17% complete response (CR) rate, surpassing Protocol 1 (7%) and Protocol 3 (6%). These rates, higher than previously documented, underscore sustained tumor regression over months to years’ post-therapy. Remarkably, nearly all complete responders (15 out of 16) remain in remission for 54+ to 99+ months. This study presents the most extensive follow-up data for melanoma patients treated with ipilimumab, affirming its potential to induce enduring, potentially curative tumor regression in select metastatic melanoma cases. Notably, the combination of ipilimumab and IL-2 demonstrates an elevated CR rate, warranting further investigation through randomized trials.