期刊
ONCOIMMUNOLOGY
卷 10, 期 1, 页码 -出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/2162402X.2020.1863631
关键词
CTLA-4; ipilimumab; radiation; abscopal; hypofractionated radiation
资金
- NIH [P01 CA210944]
- Melanoma Research Alliance Pilot Award
This study reports the final full clinical analysis of a phase I trial of radiation with ipilimumab in patients with melanoma. Radiotherapy followed by ipilimumab was well tolerated and yielded a response rate that compares favorably to ipilimumab alone. The recommended dose for subsequent phase 2 trials was 8 Gy x 3 doses, based on these results.
We conducted a phase I dose-escalation trial of radiation with ipilimumab in patients with melanoma with >= 2 metastatic lesions. Here, we report the final full clinical analysis. Patients received RT (6 or 8 Gy x 2 or 3 doses) to a single lesion followed by 4 cycles of ipilimumab. The primary endpoint was maximum tolerated dose of RT, and secondary endpoint was response at non-radiated sites. Twenty-two patients with treatment-naive (n = 11) or treatment-refractory (n = 11) Stage IV melanoma were enrolled. There were 31 treatment-related adverse events (AEs), of which 16 were deemed immune-related. Eleven patients had grade 3 AEs (no grade 4/5). There were no dose-limiting toxicities related to the radiation/ipilimumab combination. Five of 22 patients (22.7%, 95% CI 7.8-45.4%) had partial response as best response and three (13.6%) had stable disease. Median overall survival was 10.7 months (95% CI, 4.9 months to not-estimable) and median progression-free survival 3.6 months (95% CI, 2.9 months to 7.8 months). Seven patients were still alive at the time of last follow-up (median follow-up 89.2 months), most of whom received pembrolizumab after progression. Radiotherapy followed by ipilimumab was well tolerated and yielded a response rate that compares favorably to the objective response rate with ipilimumab alone. Furthermore, 32% of patients are long-term survivors, most of whom received pembrolizumab. Based on these results, the recommended dose that was used in subsequent Phase 2 trials was 8 Gy x 3 doses.
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