Ipilimumab Adjuvant Therapy
Even after successfully removing melanoma through surgery, patients may be at risk for melanoma coming back. Ipilimumab (Yervoy) in the adjuvant setting reduces this risk by stimulating the body’s immune system to fight any remaining cancer cells.
In 2015, the U.S. Food and Drug Administration (FDA) approved ipilimumab as an adjuvant therapy (after surgery) for patients with stage III melanoma. The goal of this new use of ipilimumab is to reduce the risk of melanoma recurrence.
Patients with stage III melanoma usually undergo surgery to remove the primary melanoma on the skin and the nearby lymph nodes. With ipilimumab as adjuvant treatment after surgery, patients can experience a longer relapse-free survival (RFS).
In a recent clinical trial, researchers studied the effectiveness of ipilimumab as adjuvant therapy in patients who had already had surgery to remove melanoma tumors. The results showed that ipilimumab extended the amount of time before cancer returned by an average of 9 months. The clinical trials are ongoing to assess the potential effect of ipilimumab on overall survival rates.
Learn more about adjuvant therapy for high-risk melanoma (stages IIB, IIC, III and IV).
What Is Ipilimumab (Yervoy)?
Ipilimumab is an anti-CTLA-4 inhibitor, which is:
- A type of immunotherapy known as a checkpoint inhibitor, which helps your own immune system attack cancer cells
- An anti-CTLA-4 antibody that helps strengthen the immune system by promoting the function and growth of T cells (white blood cells that help your body fight disease)
How Does Ipilimumab (Yervoy) Work?
Ipilimumab blocks the activity of a molecule called CTLA-4, a protein that prevents T cells from attacking your normal body cells and cancer cells. The normal function of CTLA-4 is to act as a checkpoint on the immune system and prevent it from attacking the body in autoimmune diseases, such as rheumatoid arthritis and ulcerative colitis (an inflammatory bowel disease).
By blocking CTLA-4, ipilimumab increases your immune system’s response to melanoma cells and tumors. The drug works to activate T cells so that they can multiply and attack melanoma cells anywhere in your body.
Which Patients May Benefit from Ipilimumab (Yervoy)?
The U.S. Food and Drug Administration (FDA) approved ipilimumab in 2011 to treat patients who have advanced stages of melanoma:
- Stage III that is unresectable (unable to be completely removed by surgery)
- Stage IV, also known as metastatic (melanoma cells that have spread to organs and other parts of the body)
Ipilimumab may not be right for certain patients, such as those who are receiving active immunosuppressive therapy for an active autoimmune condition such as:
- Crohn’s disease
- Multiple sclerosis
- Rheumatoid arthritis
- Systemic lupus erythematosus (SLE)
- Ulcerative colitis
Patients should discuss ipilimumab and other immunotherapy treatments with their physicians to understand the potential risks and benefits of a particular treatment.
How Is Ipilimumab (Yervoy) Given?
Patients receive ipilimumab intravenously (into a blood vein).
- Each dose takes about 90 minutes to complete.
- Patients receive ipilimumab on an outpatient basis without the need for a hospital stay.
- For adjuvant treatment of melanoma, patients receive ipilimumab:
- First: In doses of 10 mg/kg every 3 weeks for up to 4 doses
- Subsequently: In doses of 10 mg/kg every 12 weeks for up to 3 years
Because the dose of ipilimumab as adjuvant therapy is higher than the dose for metastatic melanoma, the side effects can be more serious. Patients should talk with their physicians to learn more about the increased side effects of ipilimumab as adjuvant therapy.
What Are the Goals of Ipilimumab (Yervoy)?
In the adjuvant setting, the goal of Ipilimumab is to reduce the risk of melanoma returning following surgery.
Melanoma treatments, like ipilimumab, have side effects, which can sometimes be serious. Patients should talk with their physician to learn more about the side effects of ipilimumab and other melanoma treatment options.
What Should I Ask My Doctor About Adjuvant Ipilimumab (Yervoy)?
It’s important to keep in mind that not all treatments work for all patients. If you are interested in learning more about ipilimumab, here are some questions you should ask your physicians:
- Will my melanoma tumor be tested for BRAF genetic mutations?
- Am I eligible for ipilimumab?
- What is your experience with ipilimumab?
- Is ipilimumab a good option for my melanoma treatment?
- Is there an alternative to ipilimumab for me?
- How successful has ipilimumab been for patients like me?
- What are the side effects of ipilimumab?
- Are there any clinical trials for ipilimumab that I should consider?
- What other treatments are FDA-approved for treating adjuvant therapy of melanoma?
- What are the risks and benefits of the available treatment options?
- What are the goals for my treatment?
Latest Treatments for Melanoma
Learn more about the latest, most effective treatments for patients who have advanced melanoma:
- Other types of immunotherapy, including:
- Targeted therapy
- Combination therapy
- Adjuvant therapy for high-risk melanoma
Since its founding in 2007, the Melanoma Research Alliance has awarded over $100 million to research aimed at better preventing, diagnosing and treating melanoma. Learn more about our funded research.
Updated: January 2018
Last reviewed: May 2016
Reviewers: John Kirkwood, Lynn Schuchter, Louise Perkins