title: Ipilimumab in the treatment of advanced melanoma - a clinical update.
abstract: BACKGROUND
  Ipilimumab has become an important treatment option for patients with advanced melanoma; however, active research perseveres to resolve many clinical practice issues and to further improve the therapeutic index of this agent.
  
  
  METHODS
  This article aims to provide an update on long-term data, current challenge and recent progress relating to the clinical application of ipilimumab in the treatment of advanced melanoma. A literature search using PubMed database was conducted using search words ipilimumab, melanoma, treatment sequencing, adjuvant therapy, combination therapy, and biomarkers. Data were also obtained from meeting abstracts and clinical trial registries.
  
  
  CONCLUSIONS
  Signal of clinical activity as adjuvant therapy in patients with resected high-risk melanoma begins to emerge, but longer follow-up is required for confirmation. Many issues, such as optimal dosing schedules and therapeutic sequences, remain unraveled. At present, treatment should be individualized based on patient- and disease-specific factors. Immunotherapy like ipilimumab still represents the best treatment option for durable remission; however, targeted therapies are more appropriate for patients with BRAF V600-mutated tumor who are symptomatic or have rapidly growing disease. With novel therapeutic options in the pipeline, the role of ipilimumab continues to evolve in the rapidly changing treatment landscape of advanced melanoma. Most likely, this agent will be utilized in combinatorial or sequential approach.
authors.affiliation: The University of Texas MD Anderson Cancer Center, Department of Melanoma Medical Oncology , 1515 Holcombe Boulevard, Box 430, Houston, TX 77030 , USA wenjhwu@mdanderson.org.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Kim
authors.forename: Van Anh
authors.initials: VA
authors.lastname: Trinh
authors.forename: Wen-Jen
authors.initials: WJ
authors.lastname: Hwu
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002986:Clinical Trials as Topic / Q000639:trends; D003131:Combined Modality Therapy / Q000639:trends; D006801:Humans; D007167:Immunotherapy / Q000639:trends; D000074324:Ipilimumab; D008545:Melanoma / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000074324:Ipilimumab
keywords: adjuvant therapy; biomarkers; combination therapy; ipilimumab; melanoma; treatment sequencing