This observation that most pa tients seem to obtain a state of tumour control rather than one of http://www.selleckchem.com/products/Tubacin.html complete tumour eradication gives credence to the concept that clinical cure or long term cancer containment is VE-822? possible, and requires induction of an antitumour immune response. The AE profile seen in patients receiving ipilimumab in the EAP was consistent with that reported in previous clinical trials of ipilimumab 10 mg/kg, with most events being dermatological or gastrointestinal in nature. Among 155 patients treated with ipilimumab 10 mg/kg in a phase 2 trial, 84% of patients had treatment related AEs of any grade, with one treatment related death resulting from liver failure.
In our ana lysis, 61% of patients had treatment related AEs of any grade and there were no treatment related deaths.
Rates of grade 3 AEs appeared similar to those seen in previ ous clinical trials of ipilimumab 3 mg/kg, but were lower than has been observed in clinical trials of ipilimumab 10 mg/kg. In a trial of ipilimumab 0. 3, 3 and 10 mg/kg in pretreated patients with advanced melan oma, the rate and severity of AEs increased with increas ing dose. therefore the lack of high grade events in this analysis is perhaps surprising, although the retrospective nature of this analysis may have influenced the number of AEs reported. Prompt recognition of symptoms and appropriate management are essential to minimise life threatening complications from ipilimumab.
A decrease in the percentage of patients requiring intervention for bowel perforation from 0. 9% to 0.
5%, for example, was thought to be due to the introduction of management guidelines established over the course of ipilimumabs clinical development. It is possible, therefore, that an increased awareness of the specific AEs associated with ipilimumab, together with the implementation and consistent use of established treatment algorithms, may have contributed to the safety profile observed in this analysis. The availability of these Anacetrapib treatment algorithms also means that, after thorough education on the appro priate management http://www.selleckchem.com/products/Tipifarnib(R115777).html methods, ipilimumab 10 mg/kg can be administered by community Batimastat based clinicians, thus ex tending its use beyond specialised treatment centres.
Conclusions Results from this analysis of heavily pretreated patients with advanced melanoma who received ipilimumab 10 mg/kg as part of an EAP in Italy suggest that the site the clin ical activity and safety profile of ipilimumab in a real world setting is similar to that observed in clinical trials. Importantly, long term survival benefits were observed in patients who had a particularly poor prognosis and had failed to benefit from prior therapy, with some patients surviving at least 3 years from the start of ipilimumab treatment.