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Immunotherapy following regional chemotherapy treatment of advanced extremity melanoma.

Publication ,  Journal Article
Jiang, BS; Beasley, GM; Speicher, PJ; Mosca, PJ; Morse, MA; Hanks, B; Salama, A; Tyler, DS
Published in: Ann Surg Oncol
August 2014

PURPOSE: Following regional chemotherapy (RC) for melanoma, approximately 75 % of patients will progress. The role of immunotherapy after RC has not been well established. METHODS: A prospective, single-institution database of 243 patients with in-transit melanoma (1995-2013) was queried for patients who had progression of disease after RC with melphalan and subsequently received systemic immunotherapy. Fifteen patients received IL-2 only, 12 received ipilimumab only, and 6 received IL-2 followed by ipilimumab. Fisher's exact test was used to determine if there was a difference in number of complete responders after immunotherapy. RESULTS: With IL-2 alone, all patients progressed. After ipilimumab alone, three patients had a complete response and nine had progressive disease. Six additional patients received IL-2 first then ipilimumab. All six progressed on IL-2 but three went on to have a complete response to ipilimumab while three progressed. The use of ipilimumab at any time in patients who progressed after RC was associated with higher rate of complete response compared to use of IL-2 alone (33 vs. 0 %; p = 0.021). CONCLUSIONS: Patients with progression after regional therapy for melanoma may benefit from immunologic therapy. In this group of patients, immune checkpoint blockade with ipilimumab has a higher complete response rate than T cell stimulation with IL-2, with no complete responders in the IL-2 only group. Furthermore, the complete response rate for ipilimumab in our cohort is higher than reported response rates in the literature for ipilimumab alone, suggesting that the effects of immunotherapy may be bolstered by previous regional treatment.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

August 2014

Volume

21

Issue

8

Start / End Page

2525 / 2531

Location

United States

Related Subject Headings

  • Survival Rate
  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Molecular Targeted Therapy
  • Middle Aged
  • Melphalan
  • Melanoma
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Jiang, B. S., Beasley, G. M., Speicher, P. J., Mosca, P. J., Morse, M. A., Hanks, B., … Tyler, D. S. (2014). Immunotherapy following regional chemotherapy treatment of advanced extremity melanoma. Ann Surg Oncol, 21(8), 2525–2531. https://doi.org/10.1245/s10434-014-3671-0
Jiang, Betty S., Georgia M. Beasley, Paul J. Speicher, Paul J. Mosca, Michael A. Morse, Brent Hanks, April Salama, and Douglas S. Tyler. “Immunotherapy following regional chemotherapy treatment of advanced extremity melanoma.Ann Surg Oncol 21, no. 8 (August 2014): 2525–31. https://doi.org/10.1245/s10434-014-3671-0.
Jiang BS, Beasley GM, Speicher PJ, Mosca PJ, Morse MA, Hanks B, et al. Immunotherapy following regional chemotherapy treatment of advanced extremity melanoma. Ann Surg Oncol. 2014 Aug;21(8):2525–31.
Jiang, Betty S., et al. “Immunotherapy following regional chemotherapy treatment of advanced extremity melanoma.Ann Surg Oncol, vol. 21, no. 8, Aug. 2014, pp. 2525–31. Pubmed, doi:10.1245/s10434-014-3671-0.
Jiang BS, Beasley GM, Speicher PJ, Mosca PJ, Morse MA, Hanks B, Salama A, Tyler DS. Immunotherapy following regional chemotherapy treatment of advanced extremity melanoma. Ann Surg Oncol. 2014 Aug;21(8):2525–2531.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

August 2014

Volume

21

Issue

8

Start / End Page

2525 / 2531

Location

United States

Related Subject Headings

  • Survival Rate
  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Molecular Targeted Therapy
  • Middle Aged
  • Melphalan
  • Melanoma
  • Male