title: Ipilimumab in the treatment of metastatic melanoma: management of adverse events.
abstract: Recently, "ipilimumab," an anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) monoclonal antibody, has been demonstrated to improve overall survival in metastatic melanoma. "CTLA-4" is an immune-checkpoint molecule that downregulates pathways of T-cell activation. Ipilimumab, by targeting CTLA-4, is able to remove the CTLA-4 inhibitory signal, allowing the immune system to react to cancer cells. Due to its immune-based mechanism of action, ipilimumab causes the inhibition of CTLA-4-mediated immunomodulatory effects, the enhancement of antitumor specific immune response mediated by the weakening of self-tolerance mechanisms while exacerbating the development of autoimmune diseases and immune-related adverse events, including dermatitis, hepatitis, enterocolitis, hypophysitis, and uveitis.
authors.affiliation: Department of Medicine, University of Salerno, Salerno, Italy ; Division of Oncology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Della Vittoria Scarpati
authors.affiliation: Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
authors.forename: Celeste
authors.initials: C
authors.lastname: Fusciello
authors.affiliation: Head and Neck Medical Oncology Unit, National Tumor Institute, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sabbatino
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Soldano
authors.initials: S
authors.lastname: Ferrone
authors.affiliation: Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Carlomagno
authors.affiliation: Department of Medicine, University of Salerno, Salerno, Italy ; Division of Oncology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pepe
keywords: CTLA-4; T-cells; adverse events; autoimmunity; melanoma