title: Patient perspectives on ipilimumab across the melanoma treatment trajectory.
abstract: Ipilimumab was the first FDA-approved agent for advanced melanoma to improve survival and represents a paradigm shift in melanoma and cancer treatment. Its unique toxicity profile and kinetics of treatment response raise novel patient education challenges. We assessed patient perceptions of ipilimumab therapy across the treatment trajectory.
  
  
  
  Four patient cohorts were assessed at different time points relative to treatment initiation: (1) prior to initiation of ipilimumab (n = 10), (2) at weeks 10-12 before restaging studies (n = 11), (3) at week 12 following restaging studies indicating progression of disease (n = 10), and (4) at week 12 following restaging studies indicating either a radiographic response or disease stability (n = 10). Patients participated in a semistructured qualitative interview to assess their experiences with ipilimumab. Quality of life was assessed via the Functional Assessment of Cancer Therapy-General and its Melanoma-specific module.
  
  
  
  Perceived quality of life was comparable across cohorts, and a majority of the sample understood side effects from ipilimumab and the potential for a delayed treatment response. Patients without progression of disease following restaging studies at week 12 held more positive views regarding ipilimumab compared to patients who had progressed.
  
  
  
  Patients generally regarded ipilimumab positively despite the risk of unique toxicities and potential for delayed therapeutic responses; however, those with progression expressed uncertainty regarding whether taking ipilimumab was worthwhile. Physician communication practices and patient education regarding realistic expectations for therapeutic benefit as well as unique toxicities associated with ipilimumab should be developed so that patients can better understand the possible outcomes from treatment.
authors.affiliation: Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th floor, New York, NY, 10022, USA.
authors.forename: Elyse
authors.initials: E
authors.lastname: Shuk
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Shoushtari
authors.affiliation: University of Chicago Comprehensive Cancer Center, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Luke
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Postow
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Maggie
authors.initials: M
authors.lastname: Callahan
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Harding
authors.affiliation: Mather Hospital, 12 Medical Drive, Suite D, Port Jefferson Station, NY, 11776, USA.
authors.forename: Katherine G
authors.initials: KG
authors.lastname: Roth
authors.affiliation: Spaulding Rehabilitation Hospital, 300 1st Ave., Charlestown, MA, 02113, USA.
authors.forename: Marisa
authors.initials: M
authors.lastname: Flavin
authors.affiliation: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Granobles
authors.affiliation: Columbia University College of Physicians and Surgeons, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10032, USA.
authors.forename: Jana
authors.initials: J
authors.lastname: Christian
authors.affiliation: Hofstra University, 1000 Fulton Ave, Hempstead, NY, 11549, USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Gold
authors.affiliation: The Gordon F. Derner Institute of Advanced Psychological Studies, Adelphi University, Hy-Weinberg Center, 1 South Avenue, Room 302, P.O. Box 701, Garden City, NY, 11530-0701, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Schoenhammer
authors.affiliation: Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th floor, New York, NY, 10022, USA.
authors.forename: Mallorie
authors.initials: M
authors.lastname: Gordon
authors.affiliation: Memorial Sloan Kettering Cancer Center, 300 East 66th Street, Room 1251, New York, NY, 10065, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cimaglia
authors.affiliation: Mount Sinai Beth Israel, 325 West 15th Street, Room G11, New York, NY, 10011, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Dyson
authors.affiliation: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Noah
authors.initials: N
authors.lastname: Goodman-Davis
authors.affiliation: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Marta N
authors.initials: MN
authors.lastname: Colgan
authors.affiliation: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Itisha S
authors.initials: IS
authors.lastname: Jefferson
authors.affiliation: Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, Av. Dr. Arnaldo, 251. 5th floor, São Paulo, 01246-000, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Munhoz
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 300 East 66th Street, Room 1251, New York, NY, 10065, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: D'Angelo
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Jedd
authors.initials: J
authors.lastname: Wolchok
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Chapman
authors.affiliation: Weill Cornell Medical College, 1300 York Ave., New York, 10065, NY, USA.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
authors.forename: Ping
authors.initials: P
authors.lastname: Chi
authors.affiliation: Columbia University Medical Center, 161 Fort Washington Avenue, HIP 9, New York, NY, 10032, USA. rdc2150@cumc.columbia.edu.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Carvajal
authors.affiliation: Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th floor, New York, NY, 10022, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D000074324:Ipilimumab; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D000074324:Ipilimumab
keywords: FACT-G; FACT-M; Ipilimumab; Melanoma; Patient-reported quality of life; Qualitative research