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

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 hadmore » an increased duration of irradiated tumor response.« less

Authors:
 [1];  [2];  [3]; ;  [4];  [3];  [5];  [2];  [5]
  1. School of Medicine, Duke University Medical Center, Durham, North Carolina (United States)
  2. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)
  3. Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States)
  4. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina (United States)
  5. Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina (United States)
Publication Date:
OSTI Identifier:
22648782
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MELANOMAS; PATIENTS; RADIOTHERAPY; TOXICITY

Citation Formats

Qin, Rosie, Olson, Adam, Singh, Bhavana, Thomas, Samantha, Wolf, Steven, Bhavsar, Nrupen A., Hanks, Brent A., Salama, Joseph K., and Salama, April K.S., E-mail: april.salama@duke.edu. Safety and Efficacy of Radiation Therapy in Advanced Melanoma Patients Treated With Ipilimumab. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.04.017.
Qin, Rosie, Olson, Adam, Singh, Bhavana, Thomas, Samantha, Wolf, Steven, Bhavsar, Nrupen A., Hanks, Brent A., Salama, Joseph K., & Salama, April K.S., E-mail: april.salama@duke.edu. Safety and Efficacy of Radiation Therapy in Advanced Melanoma Patients Treated With Ipilimumab. United States. doi:10.1016/J.IJROBP.2016.04.017.
Qin, Rosie, Olson, Adam, Singh, Bhavana, Thomas, Samantha, Wolf, Steven, Bhavsar, Nrupen A., Hanks, Brent A., Salama, Joseph K., and Salama, April K.S., E-mail: april.salama@duke.edu. Thu . "Safety and Efficacy of Radiation Therapy in Advanced Melanoma Patients Treated With Ipilimumab". United States. doi:10.1016/J.IJROBP.2016.04.017.
@article{osti_22648782,
title = {Safety and Efficacy of Radiation Therapy in Advanced Melanoma Patients Treated With Ipilimumab},
author = {Qin, Rosie and Olson, Adam and Singh, Bhavana and Thomas, Samantha and Wolf, Steven and Bhavsar, Nrupen A. and Hanks, Brent A. and Salama, Joseph K. and Salama, April K.S., E-mail: april.salama@duke.edu},
abstractNote = {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.},
doi = {10.1016/J.IJROBP.2016.04.017},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 96,
place = {United States},
year = {Thu Sep 01 00:00:00 EDT 2016},
month = {Thu Sep 01 00:00:00 EDT 2016}
}