Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders
Kaehler KC, Eigentler TK, Gesierich A, Heinzerling L, Loquai C, Meier F, Meiss F, Pfoehler C, Schlaak M, Terheyden P, Thoms KM, Ziemer M, Zimmer L, Gutzmer R (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 67
Pages Range: 825-834
Journal Issue: 5
DOI: 10.1007/s00262-018-2134-z
Abstract
BACKGROUND: Ipilimumab and programmed death (PD) 1-antibodies are effective treatment options in metastatic melanoma. The safety and efficacy of ipilimumab in patients with pre-existing autoimmune disorders (AD) has only been evaluated in a selected number of patients. METHODS: We performed a retrospective analysis in 14 German skin cancer centers for patients with metastatic melanoma and pre-existing AD treated with ipilimumab. RESULTS: 41 patients with 44 pre-existing AD were treated with ipilimumab (thyroiditis n = 15, rheumatoid n = 11, dermatologic n = 10, Crohn's disease/ulcerative colitis n = 3, neurological n = 2, sarcoidosis n = 2, pancreatitis n = 1). 3 out of 41 patients had two AD, 11 patients required immunosuppressants at the time of induction of ipilimumab. 12 patients (29.2%) experienced a flare of their pre-existing AD, mainly patients with rheumatoid or dermatologic diseases. Additional immune-related adverse events (irAEs) occurred in 12 patients (29.2%). In 23 patients (56%) neither a change of their AD nor additional irAEs were observed. Objective responses were seen in five patients (one complete remission, four partial remissions, 12.1%). CONCLUSION: This is the largest series of patients with pre-existing AD and treatment with ipilimumab reported. Flares of pre-existing AD were observed but manageable. Response rates and occurrence of new irAEs were comparable to previous trials. Thus, in this patient subgroup, ipilimumab can be a treatment option after a thorough discussion of pros and cons and taking severity and activity of the preexisting AD into account.
Authors with CRIS profile
Involved external institutions
Universitätsklinikum Köln
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Universität Duisburg-Essen (UDE)
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Universitätsklinikum Leipzig
Germany (DE)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Universitätsklinikum Göttingen
Germany (DE)
Universität des Saarlandes (UdS)
Germany (DE)
Albert-Ludwigs-Universität Freiburg
Germany (DE)
Eberhard Karls Universität Tübingen
Germany (DE)
Technische Universität Dresden
Germany (DE)
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Universität Duisburg-Essen (UDE)
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Universitätsklinikum Leipzig
Germany (DE)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Universitätsklinikum Göttingen
Germany (DE)
Universität des Saarlandes (UdS)
Germany (DE)
Albert-Ludwigs-Universität Freiburg
Germany (DE)
Eberhard Karls Universität Tübingen
Germany (DE)
Technische Universität Dresden
Germany (DE)
How to cite
APA:
Kaehler, K.C., Eigentler, T.K., Gesierich, A., Heinzerling, L., Loquai, C., Meier, F.,... Gutzmer, R. (2018). Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders. Cancer Immunology, Immunotherapy, 67(5), 825-834. https://doi.org/10.1007/s00262-018-2134-z
MLA:
Kaehler, Katharina C., et al. "Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders." Cancer Immunology, Immunotherapy 67.5 (2018): 825-834.
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