More about ipilimumab, but not in prostate cancer

One of the really “hot” pieces of news from ASCO today was the result of a Phase III clinical trial of ipilimumab in a form of metastatic skin cancer called melanoma. This is (perhaps) very important for prostate cancer patients.

Melanoma — also known as malignant melanoma — is a type of skin cancer, and is one of the most dangerous forms of cancer once it has metastasized. As for patients with hormone-refractory prostate cancer, there has been very little we could do for a patient with metastatic melanoma. However, in the trial data presented today, O’Day et al. demonstrated that ipilimumab alone was able to extend — by several months — the survival of patients with malignant melanoma who had failed both forms of standard therapy. This survival benefit is huge for patients with late stage melanoma.

Why is this important to prostate cancer patients? Because ipilimumab has already demonstrated activity in relatively early stage forms of prostate cancer and because two Phase III clinical trials are already investigating the potential of ipilimumab in treatment of castration-resistant prostate cancer.

The first of these trials is already enrolling patients and is exploring the effect of ipilimumab compared to placebo in the treatment of patients with castration-resistant prostate cancer who have received prior chemotherapy with a docetaxel-based regimen.

A second, randomized, multi-center, Phase III clinical trial will soon be starting that is designed to compare ipilimumab to placebo in patients with asymptomatic or minimally symptomatic patients with metastatic chemotherapy-naïve, castration-resistant prostate cancer.

There is a significant possibility that ipilimumab will become the first monoclonal antibody to demonstrate a survival benefit in the treatment of castration-resistant prostate cancer. If that is the case, it will set up the possibility of exploring the activity of ipilimumab in combination with other drugs as a treatment for progressive prostate cancer not just in late stages of the disease, but earlier in the disease state as well.

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