A retrospective analysis of High-Dose Interleukin-2 (HD IL-2) following Ipilimumab in metastatic melanoma.

Abstract

BACKGROUND:

High dose interleukin-2 (HD IL-2) can induce durable responses in a subset of patients leading to long-term survival. Immune checkpoint blockade (ICB) has demonstrated similarly durable responses in a larger proportion of patients. However, not all patients respond to immune checkpoint blockade and subsequent therapeutic options need to be explored.

METHODS:

The PROCLAIM database was queried for patients with metastatic melanoma who had received HD IL-2 after treatment with ipilimumab or without prior ICB. Patient characteristics, toxicity and efficacy were analyzed.

RESULTS:

A total of 52 metastatic melanoma patients were treated with high dose IL-2 after ipilimumab and 276 patients were treated with high dose IL-2 without prior ICB. The overall response rate in the prior ipilimumab group was 21 % as compared to 12 % in the group that had not received prior ipilimumab. The median overall survival, measured from the initiation of HD IL-2 therapy, was 19.3 months in the prior ipilimumab group and 19.4 months in the no prior ICB group. Toxicities observed on HD IL-2 were relatively equivalent between the groups although there were cases of CTLA4 antibody-induced colitis reported after HD IL-2 treatment and a CTLA4 antibody-induced colitis related death.

CONCLUSION:

In this retrospective analysis HD IL-2 therapy displayed antitumor activity in melanoma patients who progressed following treatment with ipilimumab. Most HD IL-2 toxicity was not worsened by prior ipilimumab therapy except for one treatment related death from colitis. Care should be taken to avoid reactivation of CTLA4 antibody-induced colitis.

• Authors: Elizabeth I Buchbinder, Anasuya Gunturi, Jessica Perritt, Janice Dutcher, Sandra Aung, Howard L Kaufman, Marc S Ernstoff, Girald P Miletello, Brendan D Curti, Gregory A Daniels, Sapna P Patel, John M Kirkwood, Sigrun Hallmeyer, Joseph I Clark, Rene Gonzalez, John M Richart, Joe Lutzky, Michael A Morse, Ryan J Sullivan, David F McDermott
• Journal: Journal for immunotherapy of cancer (J Immunother Cancer) Vol. 4 Pg. 52 ( 2016) ISSN: 2051-1426 [Print] England
• PMID: 27660706 (Publication Type: Journal Article)