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is immune-based and includes ipilimumab and interleukin-2 (IL-2), which have activity regardless of BRAF mutational status. Ipilimumab is a monoclonal antibody that blocks the immune checkpoint CTLA-4 (cytotoxic T-lymphocyte antigen 4) and has

However, interest has turned to new drug classes, including anti-CTLA4 antibodies and inhibitors of BRAF, which exploit the propensity of immune recognition and inhibition of signal-transduced growth/proliferation, respectively. The BRAF “driver” mutation

. Association of ipilimumab therapy for advanced melanoma with secondary adrenal insufficiency: a case series . Endocr Pract 2012 ; 18 : 351 – 355 . 14. Yang JC Hughes M Kammula U . Ipilimumab (anti-CTLA4 antibody) causes regression of metastatic

: Ipilimumab (anti-CTLA4) has been used off-label in 5 patients with 2 successes. 54 Prospective trials of ipilimumab (either alone or in combination with radiation and/or nivolumab) are ongoing ( ClinicalTrials.gov identifiers: NCT03071406, NCT02488759) and

-third of UMs will ultimately metastasize. 1 , 2 In the setting of metastatic disease, treatment options are limited and prognosis is poor. Immunotherapies, specifically those targeting PD-1 and cytotoxic T-lymphocyte antigen-4 (CTLA-4), have transformed

Another study showed that the microbiome is predictive not only of response but also of toxicity: the investigators demonstrated that the presence of a certain species of microbe may be protective against the development of colitis from anti–CTLA-4 therapy

/unresectable melanoma. Ipilimumab is a human monoclonal antibody that binds to the cytotoxic T-lymphocyte antigen-4 (CTLA-4), blocks the corresponding immune checkpoint signal, and results in lymphocyte proliferation and immune stimulation. The FDA approved ipilimumab

-1 and CTLA-4 pathways, comparing combination nivolumab + ipilimumab to the EXTREME regimen as first-line treatment in patients with recurrent/metastatic HNSCC ( ClinicalTrials.gov identifier: NCT02741570). Patients with PD-L1–positive tumors appear

selection of ICIs (either as monotherapy or in combination) have received accelerated FDA approvals in the second-line setting based on earlier levels of data in phase I/II studies: nivolumab, 13 pembrolizumab, 14 and nivolumab in combination with the CTLA

immune-related toxicities after treatment with the CTLA-4 antibody ipilimumab in combination with gemcitabine + cisplatin. 5 This chemoimmunotherapy regimen did not appear to impact OS. Furthermore, another study suggested that chemotherapy may promote