Ipilimumab administered to metastatic melanoma patients who progressed after dendritic cell vaccination.
Ipilimumab has proven to be effective in metastatic melanoma patients. The purpose of this study was to determine the efficacy of ipilimumab in advanced melanoma patients who showed progressive disease upon experimental dendritic cell (DC) vaccination.



Retrospective analysis of 48 stage IV melanoma patients treated with ipilimumab after progression upon DC vaccination earlier in their treatment. DC vaccination was given either as adjuvant treatment for stage III disease (n = 18) or for stage IV disease (n = 30). Ipilimumab (3 mg/kg) was administered every 3 weeks for up to 4 cycles.



Median time between progression upon DC vaccination and first gift of ipilimumab was 5.4 mo. Progression-free survival (PFS) rates for patients that received ipilimumab after adjuvant DC vaccination, and patients that received DC vaccination for stage IV melanoma, were 35% and 7% at 1 y and 35% and 3% at 2 y, while the median PFS was 2.9 mo and 3.1 mo, respectively. Median overall survival of patients pre-treated with adjuvant DC vaccination for stage III melanoma was not reached versus 8.0 mo (95% CI, 5.2-10.9) in the group pre-treated with DC vaccination for stage IV disease (HR of death, 0.36; p = 0.017). Grade 3 immune-related adverse events occurred in 19% of patients and one death (2%) was related to ipilimumab.



Clinical responses to ipilimumab were found in a considerable number of advanced melanoma patients with progression after adjuvant DC vaccination for stage III disease, while the effect was very limited in patients who showed progression after DC vaccination for stage IV disease.
Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Steve
S
Boudewijns
Department of Medical Oncology, Radboud University Medical Centre , Nijmegen, the Netherlands.
Rutger H T
RH
Koornstra
Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Harm
H
Westdorp
Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center , Nijmegen, the Netherlands.
Gerty
G
Schreibelt
Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center , Amsterdam, the Netherlands.
Alfons J M
AJ
van den Eertwegh
Department of Medical Oncology, Netherlands Cancer Institute , Amsterdam, the Netherlands.
Marnix H
MH
Geukes Foppen
Department of Medical Oncology, Netherlands Cancer Institute , Amsterdam, the Netherlands.
John B
JB
Haanen
Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
I Jolanda M
IJ
de Vries
Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center , Nijmegen, the Netherlands.
Carl G
CG
Figdor
Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Kalijn F
KF
Bol
Department of Medical Oncology, Radboud University Medical Centre , Nijmegen, the Netherlands.
Winald R
WR
Gerritsen
Dendritic cell vaccination; immunotherapy; ipilimumab; melanoma